TY - JOUR
T1 - Laparoscopic adrenalectomy for large unilateral pheochromocytoma
T2 - Experience in a large academic medical center
AU - Perry, Kyle A.
AU - El Youssef, Raphael
AU - Pham, Thai H.
AU - Sheppard, Brett C.
PY - 2010/6
Y1 - 2010/6
N2 - Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.
AB - Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.
KW - Adrenalectomy
KW - Laparoscopic adrenalectomy
KW - Laparoscopy
KW - Pheochromocytoma
UR - http://www.scopus.com/inward/record.url?scp=77955654606&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955654606&partnerID=8YFLogxK
U2 - 10.1007/s00464-009-0801-z
DO - 10.1007/s00464-009-0801-z
M3 - Article
C2 - 20033709
AN - SCOPUS:77955654606
VL - 24
SP - 1462
EP - 1467
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
IS - 6
ER -