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Laparoscopic adrenalectomy for large pheochromocytoma
Author(s) -
Indupur Ravish R.,
Nerli Rajendra B.,
Reddy Mallikarjun N.,
Siddappa Suresh N.,
Thakkar Rohan
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07179.x
Subject(s) - medicine , adrenalectomy , pheochromocytoma , surgery , laparoscopy , malignancy , clipping (morphology) , blood loss , linguistics , philosophy
OBJECTIVES To determine the feasibility and safety of laparoscopic adrenalectomy for large adrenal pheochromocytomas as although the safety and efficacy for small pheochromocytomas is relatively well documented its use for large pheochromocytomas is controversial because of a perceived increased risk of malignancy. PATIENTS AND METHODS All pheochromocytomas (>8 cm) managed prospectively using a laparoscopic approach between January 2002 and April 2006 were included. Blood loss, operative duration, complications, and hospital stay were assessed. RESULTS In all , 11 consecutive patients underwent laparoscopic adrenalectomy for large pheochromocytomas. The adrenal sizes were 8–15 cm. The mean blood loss was <100 mL, the mean operative duration was 145 min and the mean postoperative stay was 3.6 days. Only one patient had an intraoperative hypertensive crisis, and recovery was uneventful in all. CONCLUSIONS Laparoscopic transperitoneal, lateral adrenalectomy is safe and efficient means of resecting large (>8 cm) adrenal pheochromocytomas. Although intraoperative catecholamine surges are a cause of major concern, early clipping and dividing of the adrenal vein helps to avoid a catecholamine‐induced hypertensive crisis.