Laparoscopic adrenalectomy for pheochromocytoma.
OBJECTIVE
To determine the safety and results of laparoscopic resection of benign pheochromocytomas.


METHODS
We retrospectively reviewed the medical charts of all patients who underwent laparoscopic adrenalectomy for benign pheochromocytomas at all 3 Mayo Clinic sites between January 1, 1992, and December 31, 2001. Demographics, comorbidities, clinical presentation, imaging studies, biochemical findings, operative intervention, and outcome were examined. Long-term follow-up was obtained via chart review and/or by direct telephone contact with the patient or a relative.


RESULTS
Twenty-four women and 23 men with a mean age of 53.1 years (range, 16-81 years) underwent attempted laparoscopic resection of pheochromocytomas. In 5 patients, the procedure was converted to open laparotomy because of bleeding (2), inadequate exposure (2), and adhesions (1). The mean tumor size was 4.3 cm. The mean operative time (181.8 vs 1405 minutes; P = .03), mean hospital stay (6.00 vs 2.64 days; P < .001), and mean blood loss (340 mL vs 80 mL; P < .001) were greater in patients who underwent open laparotomy vs those who underwent laparoscopic resection. All specimens were classified as benign. The mean follow-up was 41 months (range, 10-89 months). No patients experienced a recurrence or developed metastatic disease.


CONCLUSIONS
In light of surgical and anesthesia expertise, laparoscopic resection of benign pheochromocytomas is safe and effective with resultant short hospital stays. A low threshold to convert to an open procedure reduces operative times and decreases potentially serious complications. Although there have been no recurrences to date, long-term follow-up is required for all patients, especially those with hereditary forms of pheochromocytomas.
Jaroszewski
Dawn E
DE
Department of Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA.
Tessier
Deron J
DJ
Schlinkert
Richard T
RT
Grant
Clive S
CS
Thompson
Geoffrey B
GB
van Heerden
Jon A
JA
Farley
David R
DR
Smith
Stephen L
SL
Hinder
Ronald A
RA
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000473:pathology / Q000601:surgery*; D011654:Pulmonary Edema / Q000209:etiology; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications; D016896:Treatment Outcome