title: Safe retroperitoneal endoscopic resection of pheochromocytomas.
abstract: Although endoscopic adrenalectomy is advocated for small adrenocortical tumors, questions remain about the safety of endoscopic retroperitoneal resection of pheochromocytomas. In this study we evaluated the outcome of retroperitoneal endoscopic adrenalectomy for pheochromocytoma. Between June 1995 and September 1999 we performed 18 retroperitoneal endoscopic adrenalectomies for a pheochromocytoma or paraganglioma. All patients received adequate alpha-adrenergic blockade. The adrenal vein was ligated at the end of the procedure. Operative blood pressure values were recorded and evaluated. Altogether 15 patients (11 women, 4 men; mean age 47.2 years) were operated on for 17 pheochromocytomas and 1 extraadrenal tumor (4 right, 11 left, 3 bilateral). One female patient was operated on at 13 weeks' gestation. Hypertensive episodes at operation were seen in 4 (26.7%) patients, and tachycardia occurred in 5 (33%). Hemodynamic changes could be corrected in all cases using simple measures without morbidity or detrimental effects. The mean operating time was 125 minutes (80-180 minutes), and the conversion rate was 5.6% (1/18). The median hospital stay was 5 days (3-28 days). Morbidity was 20% (3/15). Endoscopic retroperitoneal adrenalectomy for pheochromocytoma is safe and effective, and it is associated with limited morbidity.
authors.affiliation: Department of Surgery, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
authors.forename: Frits J
authors.initials: FJ
authors.lastname: Berends
authors.forename: Erwin Van Der
authors.initials: EV
authors.lastname: Harst
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giraudo
authors.forename: Türkan
authors.initials: T
authors.lastname: Terkivatan
authors.forename: Geert
authors.initials: G
authors.lastname: Kazemier
authors.forename: Hajo A
authors.initials: HA
authors.lastname: Bruining
authors.forename: Wouter W
authors.initials: WW
authors.lastname: De Herder
authors.forename: H Jaap
authors.initials: HJ
authors.lastname: Bonjer
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome