[A clinical study of laparoscopic adrenalectomy for pheochromocytoma--analysis of clinical parameters influencing operative time and intraoperative systolic blood pressure].
OBJECTIVE
We retrospectively analyzed the preoperative clinical parameters which influence operative time and intraoperative maximum systolic blood pressure in patients undergoing laparoscopic adrenalectomy for pheochromocytoma.


METHODS
Between January 1992 and September 2010, we performed 28 laparoscopic adrenalectomies for pheochromocytoma at Hamamatsu University School of Medicine. These 28 cases were characterized based on the following parameters: body mass index (BMI), tumor size, history of hypertension, preoperative blood pressure, serum concentration of catecholamine, and 24-h urinary excretion of catecholamine metabolite. We retrospectively analyzed whether or not these parameters influenced operative time or intraoperative maximum systolic blood pressure.


RESULTS
All 28 cases of laparoscopic adrenalectomy were performed safely and without intraoperative complications and needed neither blood transfusion nor conversion to laparotomy. The median operative time was 203 minutes, and intraoperative hypertension (systolic blood pressure > 200 mmHg) occurred in 46% (13/28) of cases. Median day of discharge in all patients was post-operative day 5. Significant positive correlation was shown between tumor size and operative time and between intraoperative maximum systolic blood pressure and serum concentration of catecholamine or 24-h urinary excretion of catecholamine metabolite (p < 0.05).


CONCLUSIONS
The lengthened operative time for large tumors and elevated intraoperative blood pressure for tumors with high preoperative catecholamine activity necessitate careful perioperative management in patients receiving laparoscopic adrenalectomy for pheochromocytoma.
Department of Urology, JA Shizuoka Kohseiren Enshu Hospital.
Toshiki
T
Ito
Yutaka
Y
Kurita
Hitoshi
H
Shinbo
Masao
M
Nagata
Tatsuya
T
Takayama
Hiroshi
H
Furuse
Soichi
S
Mugiya
Seiichiro
S
Ozono
Tomomi
T
Ushiyama
Nobuo
N
Tsuru
Kazuo
K
Suzuki
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002395:Catecholamines / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010673:Pheochromocytoma / Q000601:surgery*; D012189:Retrospective Studies
D002395:Catecholamines