What affects the results of a laparoscopic adrenalectomy for pheochromocytoma? Evaluation with respect to intraoperative blood pressure and state of tumor.
OBJECTIVE
To investigate the factors that affect the operative data and to evaluate the validity of a laparoscopic adrenalectomy (LA) for pheochromocytoma.


METHODS
Between July 1993 and January 2008, 172 LAs were performed in this department, and 34 of them were for pheochromocytoma. The characteristics and operative data of LAs for pheochromocytoma were examined with respect to the intraoperative systolic blood pressure (SBP) and the side of tumor.


RESULTS
The intraoperative SBP rose to 180 mm Hg or more in 17 (50%) cases of LAs for pheochromocytomas. The analysis of SBP (<180 versus >180 mm Hg), however, showed that there were no differences in the operative data between the two groups. The tumor size was significantly associated with operative time (P < 0.05) or the blood loss (P < 0.05) in an LA for pheochromocytoma. The blood loss in LAs for right adrenal tumors was greater (150 versus 79 mL) than for left tumors (P < 0.01). In particular, some procedures for right large tumors had considerable blood loss and long procedural time. In a comparison of the operative data between pheochromocytoma and other adrenal tumors, the tumor was larger (4.3 versus 2.5 cm) and the blood loss was greater (100 versus 30 mL) than for other adrenal tumors.


CONCLUSIONS
The operative data showed no correlation with the intraoperative high SBP, but they were associated with the tumor state. Although the procedure seems to be influenced by the size and state of tumor, LA is not contraindicated for pheochromocytoma, and it can therefore be performed safely.
Tatsugami
Katsunori
K
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ktatsu@uro.med.kyushu-u.ac.jp
Eto
Masatoshi
M
Hamaguchi
Masumitsu
M
Yokomizo
Akira
A
Harano
Masahiko
M
Naito
Seiji
S
D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D013599:Systole