Laparoendoscopic single-site retroperitoneoscopic adrenalectomy for pheochromocytoma: case selection, surgical technique, and short-term outcome.
OBJECTIVE
To present our experience with case selection and operative skills of laparoendoscopic single-site (LESS) retroperitoneoscopic adrenalectomy for pheochromocytoma and evaluate its feasibility.


METHODS
Between June 2011 and December 2012, we performed LESS retroperitoneoscopic adrenalectomy for 16 patients with pheochromocytoma. In all patients, the diameter of the pheochromocytoma was less than 4.0 cm. During the operation, a single-port access was inserted through a 2.5-3.0 cm transverse incision below the tip of the 12th rib. Internally, the operative procedure duplicates the conventional retroperitoneoscopic adrenalectomy for pheochromocytoma.


RESULTS
No conversions to open surgery or standard laparoscopy with additional trocars were necessary. The mean operative duration was 68.1 minutes (range 41-125 min). The mean blood loss was negligible (<50 mL), and no patient needed blood transfusion. Intraoperative hypertension (SBP>180 mmHg) occurred in 12.5% (2/16) of the patients. No patient had sustained hypertension, and none experienced intraoperative hypotension (systolic blood pressure <80 mm Hg). The only postoperative complication was one case of pneumonia successfully treated with antibiotics. The average postoperative hospital stay was 3.1 days (range 2-5 days). All patients left the hospital with a good cosmetic appearance.


CONCLUSIONS
In properly selected patients, LESS retroperitoneoscopic adrenalectomy is a feasible and safe procedure for pheochromocytoma.
Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan Province, China .
Yao
Y
He
Zhi
Z
Chen
Yan-Cheng
YC
Luo
Xiao-Long
XL
Fang
Xiang
X
Chen
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010673:Pheochromocytoma / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D012187:Retroperitoneal Space / Q000601:surgery*; D016896:Treatment Outcome