Comparison of Laparoscopic and Conventional Open Resection of Pheochromocytoma

Kang, Jung Mook; Choi, Jae Young; Lee, Kil Yeon; Lee, Sang Mok; Park, Ho Chul; Hong, Sung Wha; Oh, Soo Myung; Yoon, Choong; Koh, Suck Hwan

Abstract

PURPOSE: Laparoscopic adrenalectomy (LA) has become the standard treatment for benign adrenal neoplasm because of the procedure's minimal invasiveness and the patients' earlier recovery. The aim of this study was to evaluate the safety and effectiveness of laparoscopic adrenalectomy for treating pheochromocytoma.
METHODS
19 Operations were performed between March 1993 and July 2004 at Kyung-Hee medical center for treating pheochromocytoma, and the diagnosis was confirmed by the postoperative pathology. There were 5 cases treated with LA and 14 cases treated with open adrenalectomy (OA). The various clinical parameters (tumor location, tumor size, first oral feeding, hospital stay, hemodynamic change and operation time) were compared between the LA and OA procedures, retrospectively.
RESULTS
The location of the tumor was 2 : 2 : 1 (left : right : extra-adrenal) in the LA group and 9 : 3 : 2 (left : right : both) in the OA group. The mean tumor size (cm) was 5.4 in the LA group and 6.3 in the OA group. The mean operation time (minutes) was 219 in the LA group and 202 in the OA group. The resumption of liquid diet (days) was 2.2 in the LA group and 3.0 in the OA group (P=0.037). The postoperative hospital stay (days) was 6.3 in the LA group and 8.5 in the OA group. The mean number of intraoperative hypertensive crisis was 1.42 in the LA group and 1.40 in the OA group. The number of cases requiring intraoperative transfusion was 2 of 5 in the LA group and 2 of 15 in the OA group. The use of antihypertensives (number of times) was 1.42 in the LA group and 1.40 in the OA group. The mean highest BP (mmHg) was 162 in the LA group and 165 in the OA group.
CONCLUSION
Laparoscopic adrenalectomy for treating pheochromocytoma is a safe and effective procedure that provides the benefits of a minimally invasive approach.