Laparoscopic adrenalectomy --- is it any different in phaeochromocytoma and non-phaeochromocytoma?
BACKGROUND
Laparoscopic adrenalectomy (LA) for phaeochromocytoma is a feasible, safe and effective treatment. The effects of associated catecholamine release render LA more challenging, although with comparable morbidity to LA for other diseases of the adrenal gland.


METHODS
Data from case records of 44 patients who underwent LAs between May 2002 and May 2006 were analysed retrospectively. The patients were divided into a phaeochromocytoma group (Group I) and a non-phaeochromocytoma group (Group II). The aim of this study was to assess the operative course and outcome of LA in the two groups.


RESULTS
The mean operating time and blood loss were slightly higher in LA for phaeochromocytomas compared to LA for other pathologies, but these differences were not statistically significant. The mean hospital stay was 3.84 days in both groups. The phaeochromocytoma group had a slightly higher complication rate of 21% compared to 12%. None of the procedures needed open conversion. A terminal hand assist was employed in two patients in Group I and one patient in Group II. Two patients with bilateral phaeochromocytoma had single stage bilateral LA.


CONCLUSIONS
LA is feasible and effective in phaeochromocytoma. It is associated with a slightly longer operating time, more blood loss and complications when compared with non-phaeochromocytoma masses. LA can be done in a single operation for bilateral masses. Terminal hand assist is a viable and effective option for very large masses.
Tiyadath
Balagopal Nair
BN
Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India. balagopalnair@aims.amrita.edu
Sukumar
Sudhir
S
Saheed
C S Mohammed
CS
Hattangadi
Sanjay Bhat
SB
D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D018246:Adrenocortical Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D047748:Pituitary ACTH Hypersecretion / Q000601:surgery; D016896:Treatment Outcome