RESUMO
To summarize the experience of perioperative hemodynamic changes and recovery profile during laparoscopic versus open adrenalectomy for pheochromocytoma. Retrospective study. Department of Anesthesia and Critical Care and Department of Urology, IKDRC and ITS, Ahmedabad, India. Twenty-eight patients who underwent laparoscopic surgery were compared to fifteen patients who underwent open surgery under general anesthesia. Open or laparoscopic adrenalectomy. Preoperative medical history and therapy, intraoperative hemodynamic data, blood loss and postoperative outcome. Preoperative therapy with alpha-adrenergic blockers was comparable in both the groups. There was conversion to the open procedure in three patients in the laparoscopic surgery group. A comparison between the open and laparoscopic procedures did not show any significant difference between the maximum intraoperative systolic blood pressure [p = 0.232] and heart rate [p = 0.729] values although intraoperative blood pressure peaks were seen more frequently during laparoscopic adrenalectomy [17 patients [60.7%]] as compared to six [40%] of the open group]. The operative time, intraoperative blood transfusion and perioperative morbidity did not differ significantly between the two groups [p > 0.05]. 10% of patients in the laparoscopic group required rescue analgesia. Length of postoperative hospital stay was shorter in the laparoscopic group as compared to open surgery and the difference was statistically significant [p = 0.0001]. The intraoperative hemodynamic stability was comparable in open as well as laparoscopic adrenalectomy for pheochromocytoma. Patients who underwent laparoscopic surgery required lesser postoperative analgesia and had a faster postoperative recovery. Therefore, the laparoscopic approach is better