The Safety and Efficacy of Laparoscopic Transperitoneal Adrenalectomy in Patients with Pheochromocytoma / 대한비뇨기과학회지

ABSTRACT

Purpose: Pheochromocytomas are relatively uncommon tumors, the operative resection of which presents clear medical and technical challenges. We report our experience of a laparoscopic transperitoneal adrenalectomy in a series of 22 patients with a pheochromocytoma. In a comparison of the early (A) and late (B) surgery groups, the "learning curve" and efficacy and safety of a laparoscopic transperitoneal adrenalectomy for a pheochromocytoma were evaluated. Materials and Methods: Between January 1998 and August 2005, 22 patients with a pheochromocytoma underwent a laparoscopic transperitoneal adrenalectomy (LTA). Patients were divided into groups A (early surgery group, LTA between January 1998 and January 2002) and B (late surgery group, LTA February 2002 and August 2005). The operative time, intraoperative blood loss, mean time to oral intake, mean postoperative hospital stay and intraoperative hypertensive crises were analyzed retrospectively. Results: The mean operative times were 169.4 and 122.5 min in the groups A and B (p=0.003), with mean blood losses of 149.4 and 129.5cc, respectively (p=0.045). The mean postoperative hospital stays were 6.5 and 4.4 days in groups A and B, respectively (p=0.015). Intraoperative hypertensive crises occurred in two and one patient in groups A and B, respectively. With a mean follow-up of 34 months, the regression of symptoms and control of blood pressure were obtained in all patients, without additional treatment. Conclusions: In group B, the mean operative time, intraoperative blood loss and the mean postoperative hospital stay were shortened. In our experience, an adrenal pheochromocytoma can be treated safely and effectively using a laparoscopic transperitoneal approach.