title: Laparoscopic surgery for pheochromocytoma.
abstract: OBJECTIVE
  To evaluate the feasibility of laparoscopic adrenalectomy for pheochromocytoma.
  
  
  METHODS
  Between January 1998 and March 2002, 12 patients aged from 19 to 76 (average age 54 years) underwent 13 adrenalectomies (7 right and 6 left, 1 bilateral) using laparoscopic surgery. A specific anti-hypertensive preparation was begun prior to the operation. Peaks of blood pressure were treated by bolus Nicardipine and sinus tachycardia by bolus Esmolol. Catecholamines were dosed at different times during the intervention. As far as surgery was concerned, the adrenalectomies were performed 11 times using the transperitoneal route and twice using the retroperitoneal route. The adrenal vein was found and ligatured before manipulation of the adrenal gland.
  
  
  RESULTS
  Average length of operation was 127 minutes (75 to 195). Average blood loss was 105 ml (0 to 1000). Catecholamines dosed throughout showed a variable increase in plasma rates during peritoneal insufflation and manipulation of the gland. They were responsible for 5 cases of hypertensive bouts and 2 cases of tachycardia which were treated with medication. No surgical conversions were necessary. Average length of hospital stay was 4.18 days (3 to 6); average size of adrenal tumours was 44 mm (30 to 72); average follow-up, 18.4 months.
  
  
  CONCLUSIONS
  This study showed the feasibility of adrenalectomy for pheochromocytoma using laparoscopic surgery, subject to specific medical preparation to reduce the consequences of peroperative bouts of hypertension and sinus tachycardia during peritoneal insufflation and manipulation of the adrenal gland despite initial ligature of the main adrenal vein.
authors.affiliation: Department of Urology, Hôpital Pellegrin-Tondu, Centre Hospitalier Universitaire Pellegrin, 5 place Amélie Raba-Léon, 33076 Cedex, Bordeaux, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Flávio Rocha
authors.forename: Rozbeh
authors.initials: R
authors.lastname: Faramarzi-Roques
authors.forename: Patrick
authors.initials: P
authors.lastname: Tauzin-Fin
authors.forename: Vincent
authors.initials: V
authors.lastname: Vallee
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Leitao de Vasconcelos
authors.forename: Philippe
authors.initials: P
authors.lastname: Ballanger
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*