title: Retroperitoneoscopic adrenalectomy for pheochromocytoma: comparison with open surgery.
abstract: OBJECTIVE
  To evaluate the feasibility of the retroperitoneoscopic approach to adrenalectomy for pheochromocytoma and to compare it with the open retroperitoneal approach.
  
  
  METHODS
  Twelve retroperitoneoscopic adrenalectomies for pheochromocytomas were performed in 10 patients at our center between January 1996 and January 2001. Two patients underwent simultaneous bilateral surgeries. These were retrospectively compared with open adrenalectomy for pheochromocytoma through the extraperitoneal flank approach in 6 patients with 7 adrenalectomies, conducted during the same period.
  
  
  RESULTS
  Retroperitoneoscopic adrenalectomy could be successfully performed in 11 cases with 1 conversion to open surgery. Mean operative time was 151 minutes (range, 90 to 200 min). This was comparable to the time for the open surgery group, 169 minutes (range, 85 to 270 min). However, the mean blood loss of 140 mL (range, 30 to 300 mL), hospital stay of 4.4 days, and analgesia doses required (3.3) were significantly lower than those for the open surgery group (592 mL, 9.8 days, and 8.1 doses, respectively). No significant intraoperative hypertensive crises occurred in either group.
  
  
  CONCLUSIONS
  Retroperitoneoscopy is a safe and feasible option for adrenalectomy for pheochromocytoma. It requires shorter operative time, less postoperative analgesia, a shorter hospitalization, and blood loss is less. Although retroperitoneoscopy is widely practiced for other adrenal tumors, it should now also be considered for pheochromocytomas.
authors: Department of Urology, All India Institute of Medical Sciences, Ansari Nugar, New Delhi, India. akhemal@hotmail.com
authors: Ashok K
authors: AK
authors: Hemal
authors: Rajeev
authors: R
authors: Kumar
authors: Mahesh C
authors: MC
authors: Misra
authors: Narmada P
authors: NP
authors: Gupta
authors: Sunil
authors: S
authors: Chumber
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016896:Treatment Outcome