title: Laparoscopic resection of adrenal and extra-adrenal pheochromocytoma.
abstract: OBJECTIVE
  Laparoscopic resection of extra-adrenal pheochromocytoma (EAPs) necessitates meticulous surgical procedures because of changes in anatomic disposition and/or proximity to major blood vessels. Complete resection can be traumatic and may cause an increase in catecholamine levels. We present our experiences with laparoscopic resection of EAP (LEAP) and compare the intraoperative hemodynamics with those during laparoscopic resection of adrenal pheochromocytoma (LAP).
  
  
  METHODS
  We retrospectively reviewed the medical records of five patients who underwent LEAP (retrocaval EAP, n=2; interaortocaval EAP, n=1; periadrenal EAP, n=2) and five who underwent LAP between October 2001 and October 2011. We also evaluated fluctuations in blood pressure (BP) reported during both surgeries.
  
  
  RESULTS
  The tumors were successfully resected under laparoscopic guidance in both groups, and conversion to open surgery or blood transfusion was not needed. Intraoperative hypertension (BP>200 mm Hg) was observed in three LEAP and four LAP patients, whereas intraoperative hypotension (BP<80 mm Hg) was observed in five LEAP and three LAP patients. No significant differences were observed between groups, however.
  
  
  CONCLUSIONS
  Laparoscopy is the method of choice for surgeons experienced in EAP resection because it is feasible and reproducible with appropriate preoperative planning, similar to LAP.
authors.affiliation: Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan. nozaki0921@yahoo.co.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nozaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Iida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morii
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Fujiuchi
authors.forename: Akiou
authors.initials: A
authors.lastname: Okumura
authors.forename: Hideki
authors.initials: H
authors.lastname: Fuse
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome