title: Effect of early adrenal vein ligation on blood pressure and catecholeamine fluctuation during laparoscopic adrenalectomy for pheochromocytoma.
abstract: OBJECTIVE
  To define whether previous control of the adrenal vein is a crucial procedure in laparoscopic adrenalectomy for pheochromocytoma.
  
  
  METHODS
  From January 2000 to December 2010, 114 patients with pheochromocytoma who underwent laparoscopic adrenalectomy through transperitoneal or retroperitoneal approach were included. The patients were divided into 2 groups randomly (group 1: dissection after ligation; group 2: dissection before ligation). Blood samples for the measurement of catecholamines levels using high performance liquid chromatography were taken at the following time points: t1, before anesthesia; t2, during manipulation-extraction of pheochromocytoma; t3, after removal of pheochromocytoma. The blood pressure fluctuation was recorded.
  
  
  RESULTS
  Laparoscopic adrenalectomy was successfully performed on 113 patients with 1 elective open conversion because of dense peritumor adhesions. The operating time ranged from 80 to 150 minutes (mean 108, 102 in group 1, 110 in group 2). Mean blood loss ranged from 20 to 500 mL (mean 120 mL, 110 in group 1, 125 in group 2). The concentrations of plasma catecholamines between the 2 groups had no statistical differences. The blood pressure fluctuation incidence between the 2 groups had no marked difference. But the incidence increased with high functionary grade, and the difference was significant (P = .043).
  
  
  CONCLUSIONS
  This study demonstrated that previous control of the adrenal vein was not a determinate factor in dealing with dangerous hypertension during laparoscopic adrenalectomies.
authors.affiliation: Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China.
authors.forename: Guojun
authors.initials: G
authors.lastname: Wu
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Chuigong
authors.initials: C
authors.lastname: Yu
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.forename: Geng
authors.initials: G
authors.lastname: Zhang
authors.forename: Lijun
authors.initials: L
authors.lastname: Yang
authors.forename: Jianlin
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D000311:Adrenal Glands / Q000098:blood supply; D000315:Adrenalectomy / Q000379:methods*; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008026:Ligation / Q000009:adverse effects; D008297:Male; D010673:Pheochromocytoma / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D014680:Veins
chemical_list: D002395:Catecholamines