Advances in pheochromocytoma management in the era of laparoscopy.
OBJECTIVE
To understand the advances that were made in the management of pheochromocytoma since laparoscopy was initiated at our institution.


METHODS
Data for all patients who underwent surgical procedure for adrenal diseases had been recorded prospectively since September 2000, when laparoscopy was routinely initiated at our institution; all patients with a diagnosis of pheochromocytoma up to December 2005 had their data assessed (group 1). Charts for all patients with a diagnosis of pheochromocytoma who underwent surgery at our institution from 1990 to 1995 (group 2) were reviewed, and the data were compared with data from patients in group 1.


RESULTS
In group 1, 24 patients with pheochromocytoma underwent 26 procedures at our institution, including five patients with extra-adrenal tumor and one patient with bilateral tumor; 18 adrenalectomies (one bilateral) were performed, and two extra-adrenal tumors were removed using a laparoscopic approach. In group 2, ten open adrenalectomies were performed in 9 patients (1 bilateral). The patients who underwent laparoscopy for either adrenal or extra-adrenal tumor had shorter operative times and hospital stay and less bleeding.


CONCLUSIONS
Pheochromocytoma is a complex disease with potentially severe complications. Laparoscopic adrenalectomy can be safely performed for removal of either adrenal or extra-adrenal tumors. Patients spend a shorter time in the critical care unit after the procedure.
Division of Urology, Federal University of São Paulo, São Paulo, Brazil.
Eliney F
EF
Faria
Cassio
C
Andreoni
Rodrigo K
RK
Krebs
Humberto
H
Nascimento
Susan M
SM
Goldman
Claudio
C
Kater
Valdemar
V
Ortiz
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D011446:Prospective Studies