title: Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma.
abstract: BACKGROUND
  Laparoscopic adrenalectomy for pheochromocytoma remains subject of debate, owing to the systemic consequences of pneumoperitoneum in patients with catecholamine-secreting tumors.
  
  
  METHODS
  A prospective randomized study was conducted (2000-2006), evaluating cardiovascular instability during open (n = 9, group A) or laparoscopic (n = 13, group B) adrenalectomy for pheochromocytoma. Haemodynamic parameters were recorded by invasive monitoring.
  
  
  RESULTS
  Haemodynamic instability was observed in 3/9 (group A) and 6/13 patients (group B), with a mean of 1.8 and 2.2 hypertensive peaks per patient (p = n.s.). Blood loss (164 +/- 94 cc versus 48 +/- 36 cc, p < 0.05) and operative time (180 +/- 40 versus 158 +/- 45 min, p = n.s.) favored laparoscopic procedures. Postoperative morbidity and mortality were nil. Hospital stay was shorter in group B (p < 0.05). Long-term follow-up was always normal.
  
  
  CONCLUSIONS
  Laparoscopic approach for pheochromocytoma can be as safe as open surgery; intraoperative haemodynamic instability, although usually controlled with success, remains a source of concern.
authors.affiliation: Surgical Clinic, Department of Medical and Surgical Sciences, University of Brescia, 25100, Brescia, Italy. guido.tiberio@libero.it
authors.forename: Guido A M
authors.initials: GA
authors.lastname: Tiberio
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
authors.forename: Luca
authors.initials: L
authors.lastname: Arru
authors.forename: Claudia
authors.initials: C
authors.lastname: Agabiti Rosei
authors.forename: Simona
authors.initials: S
authors.lastname: De Ponti
authors.forename: Albert
authors.initials: A
authors.lastname: Matheis
authors.forename: Damiano
authors.initials: D
authors.lastname: Rizzoni
authors.forename: Stefano M
authors.initials: SM
authors.lastname: Giulini
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010673:Pheochromocytoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide