title: Laparoscopic adrenalectomy for pheochromocytoma is more difficult compared to other adrenal tumors.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is the gold standard for the treatment of benign adrenal tumors. However, some authors raise the problem of differences in surgery for pheochromocytoma in comparison to other lesions.
  
  
  OBJECTIVE
  To compare laparoscopic adrenalectomy for pheochromocytoma and for other tumors.
  
  
  METHODS
  Four hundred and thirty-seven patients with adrenal tumors were included in the retrospective analysis. Patients were divided into two groups: 1 (124 patients treated for pheochromocytoma) and 2 (313 patients with other types of tumor). The two groups were compared with respect to mean operative time, intraoperative blood loss, conversion rate, complication rate and the relationship of tumor size with operative time.
  
  
  RESULTS
  The mean operative time in group 1 was 91 min, and in group 2 it was 82 min (p = 0.016). In both groups 1 and 2, tumor size correlated with operative time (p < 0.0001 and p = 0.0003, respectively). The mean blood loss in groups 1 and 2 was 117 ml and 54 ml, respectively (p = 0.0011). The complication rate in groups 1 and 2 was 4% and 4.2%, respectively (p = 0.9542). In groups 1 and 2, conversion was necessary in 2 (1.6%) and 5 (1.6%) cases, respectively (p = 0.9925).
  
  
  CONCLUSIONS
  Longer operative time and higher blood loss after laparoscopic adrenalectomy for pheochromocytoma indicate its greater difficulty. However, despite these drawbacks, minimally invasive surgery still seems to be an effective and safe method.
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Natkaniec
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Pędziwiatr
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland ; Department of Physiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Wierdak
authors.affiliation: Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Białas
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Major
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Matłok
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Budzyński
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Dworak
authors.affiliation: Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Buziak-Bereza
authors.affiliation: 2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budzyński
keywords: adrenal tumor; laparoscopic surgery; pheochromocytoma; safety