Pheochromocytoma: a long-term follow-up of 24 patients undergoing laparoscopic adrenalectomy.
OBJECTIVE
Pheochromocytomas are tumors derived from chromaffin cells that often secrete catecholamines and cause hypertension. The clinical diagnosis of pheochromocytoma depends on the presence of excessive production of catecholamines. Conventional imaging modalities that have been used in the preoperative evaluation include CT, MRI, and 131I-MIBG scintigraphy. Surgical resection is the definitive treatment for patients with pheochromocytoma. The goal of this study was to evaluate the long-term follow-up of 24 patients undergoing laparoscopic adrenalectomy for pheochromocytoma.


METHODS
From January 1995 to September 2006, 24 patients underwent laparoscopic adrenalectomy for adrenal pheochromocytoma. Twenty (83.3%) patients had arterial hypertension. The inclusion criteria of patients in this retrospective study were laparoscopic approach, unilateral or bilateral adrenal tumor, pathological diagnosis of pheochromocytoma and a minimum follow-up of 18 months.


RESULTS
Intra-operative complications occurred in 4 (16.7%) patients. Two (8.3%) patients had postoperative complications. Two patients (8.3%) had blood transfusion. The mean postoperative hospital stay was 3.8 days (range 1 to 11). Eighteen (90%) of the twenty patients who had symptomatic hypertension, returned to normal blood pressure immediately after surgery, during the hospital stay. In one patient, the high blood pressure levels remained unchanged. Another patient persisted with mild hypertension, well controlled by a single antihypertensive drug.


CONCLUSIONS
Our results confirmed that laparoscopic adrenalectomy for pheochromocytoma is a safe and effective procedure, providing the benefits of a minimally invasive approach. In our study, the initial positive results obtained in the treatment of 24 patients were confirmed after a mean follow-up of 74 months.
Castilho
Lísias N
LN
Section of Urology, Catholic University of Campinas, Campinas, Sao Paulo, Brazil. lisias@dglnet.com.br
Simoes
Fabiano A
FA
Santos
Andre M
AM
Rodrigues
Tiago M
TM
dos Santos Junior
Carlos A
CA
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002395:Catecholamines / Q000032:analysis; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D014408:Biomarkers, Tumor; D002395:Catecholamines