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Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma

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Abstract

Background

Laparoscopic adrenalectomy for pheochromocytoma remains subject of debate, owing to the systemic consequences of pneumoperitoneum in patients with catecholamine-secreting tumors.

Methods

A prospective randomized study was conducted (2000–2006), evaluating cardiovascular instability during open (n = 9, group A) or laparoscopic (n = 13, group B) adrenalectomy for pheochromocytoma. Haemodynamic parameters were recorded by invasive monitoring.

Results

Haemodynamic instability was observed in 3/9 (group A) and 6/13 patients (group B), with a mean of 1.8 and 2.2 hypertensive peaks per patient (p = n.s.). Blood loss (164 ± 94 cc versus 48 ± 36 cc, p < 0.05) and operative time (180 ± 40 versus 158 ± 45 min, p = n.s.) favored laparoscopic procedures. Postoperative morbidity and mortality were nil. Hospital stay was shorter in group B (p < 0.05). Long-term follow-up was always normal.

Conclusions

Laparoscopic approach for pheochromocytoma can be as safe as open surgery; intraoperative haemodynamic instability, although usually controlled with success, remains a source of concern.

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References

  1. Fernandez-Cruz L, Taura P, Saenz A et al (1996) Laparoscopic approach to pheochromocytoma: hemodynamic changes and catecholamine secretion. World J Surg 20:762–768

    Article  PubMed  CAS  Google Scholar 

  2. Fernandez-Cruz L, Saenz A, Taura P et al (1998) Helium and carbon dioxide pneumoperitoneum in patients with pheochromocytoma undergoing laparoscopic adrenalectomy. World J Surg 22:1250–1255

    Article  PubMed  CAS  Google Scholar 

  3. Flavio Rocha M, Faramarzi-Roques R, Tauzin-Fin P et al (2004) Laparoscopic surgery for pheochromocytoma. Eur Urol 45:226–232

    Article  PubMed  Google Scholar 

  4. Gagner M, Lacroix A, Bolte E (1992) Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. NEJM 327:1033

    PubMed  CAS  Google Scholar 

  5. Gagner M (1996) Laparoscopic adrenalectomy. Surg Clin North Am 76:523–537

    Article  PubMed  CAS  Google Scholar 

  6. Hazzan D, Shiloni E, Golijanin D, Jurim O, Gross D, Reissman P (2001) Laparoscopic adrenalectomy for benign adrenal neoplasm. A comparative study. Surg Endosc 15:1356–1358

    Article  CAS  Google Scholar 

  7. Inabnet WB, Pitre J, Bernard D et al (2000) Comparison of the hemodynamic parameters of open and laparoscopic adrenalectomy for pheochromocytoma. World J Surg 24:574–578

    Article  PubMed  CAS  Google Scholar 

  8. Kebebew E, Duh QJ (1998) Benign and malignant pheochromocytoma. Diagnosis, treatment and follow-up. Surg Oncol Clin North Am 7:765–789

    CAS  Google Scholar 

  9. Kercher KW, Park A, Matthews BD et al (2002) Laparoscopic adrenalectomy for pheochromocytoma. Surg Endosc 16:100–102

    Article  PubMed  CAS  Google Scholar 

  10. Kercher KW, Novitsky YW, Park A, Matthews BD, Litwin DE, Heniford BT (2005) Laparoscopic curative resection of pheochromocytomas. Ann Surg 241:919–926

    Article  PubMed  Google Scholar 

  11. Lezoche E, Guerrieri M, Crosta F, Paganini A, D’Ambrosio G, Lezoche G, Campagnacci R (2008) Perioperative results of 214 laparoscopic adrenalectomies by anterior transperitoneal approach. Surg Endosc 22:522–526

    Article  PubMed  Google Scholar 

  12. Marescaux J, Mutter D, Wheeler MH (1996) Laparoscopic right and left adrenalectomies: surgical procedures. Surg Endosc 10:912–915

    Article  PubMed  CAS  Google Scholar 

  13. Miccoli P, Bendinelli C, Materazzi G, Iacconi P, Buccianti P (1997) Traditional versus laparoscopic surgery in the treatment of pheochromocytoma: a preliminary study. J Laparoendosc Surg 3:167–171

    Article  Google Scholar 

  14. Mobius E, Nies C, Rothmund M (1999) Surgical treatment of pheochromocytomas: laparoscopic or conventional? Surg Endosc 13:35–39

    Article  PubMed  CAS  Google Scholar 

  15. Prinz RA (1995) A comparison of laparoscopic and open adrenalectomies. Arch Surg 130:489–492

    PubMed  CAS  Google Scholar 

  16. Proye C, Thevenin D, Cecat P, Petillot P, Carnaille B, Wemeau JL, Huglo D, Ernst O, Proye CA (1989). Exclusive use of calcium channels blockers in preoperative and intra-operative control of pheochromocytomas: hemodynamics and free catecholamines assays in ten consecutive patients. Surgery 106:1149–1154

    PubMed  CAS  Google Scholar 

  17. Sprung J, O’Hara JF, Gill IS, Abdelmalak B, Sarnaik A, Bravo EL (2000) Anesthetic aspects of laparoscopic and open adrenalectomy for pheochromocytoma. Urology 55:339–343

    Article  PubMed  CAS  Google Scholar 

  18. Tiberio GA, Piardi T, Cerea K, Ronconi M, Bertoloni G, Frassi E, Portolani N, Giulini SM (2005) Laparoscopic adrenalectomy: an initial experience. Chir Ital 57:273–278

    PubMed  Google Scholar 

  19. Toniato A, Boschin I, Bernante P, Opocher G, Guolo AM, Pelizzo MR, Mantero F (2007) Laparoscopic adrenalectomy for pheochromocytoma: is it really more difficult? Surg Endosc 21:1323–1326

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors are very grateful to Prof. Bruno Mario Cesana of the Department of Biomedical Sciences and Biotechnology, Section of Medical Statistic, Brescia University for his valuable help in reviewing the statistical analysis of the paper.

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Authors and Affiliations

  1. Surgical Clinic, Department of Medical and Surgical Sciences, University of Brescia, 25100, Brescia, Italy

    Guido A. M. Tiberio, Gian Luca Baiocchi, Luca Arru, Simona De Ponti & Stefano M. Giulini

  2. Campus Bio-Medico University, Rome, Italy

    Guido A. M. Tiberio

  3. P.tta San Giorgio, 5, 25100, Brescia, Italy

    Guido A. M. Tiberio

  4. Internal Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy

    Claudia Agabiti Rosei & Damiano Rizzoni

  5. Department of Anaesthesia and Resuscitation, University of Brescia, Brescia, Italy

    Albert Matheis

Authors
  1. Guido A. M. Tiberio
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  2. Gian Luca Baiocchi
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  3. Luca Arru
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  4. Claudia Agabiti Rosei
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  5. Simona De Ponti
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  6. Albert Matheis
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  7. Damiano Rizzoni
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  8. Stefano M. Giulini
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Corresponding author

Correspondence to Guido A. M. Tiberio.

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Tiberio, G.A.M., Baiocchi, G.L., Arru, L. et al. Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma. Surg Endosc 22, 1435–1439 (2008). https://doi.org/10.1007/s00464-008-9904-1

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  • DOI: https://doi.org/10.1007/s00464-008-9904-1

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