Laparoscopic adrenalectomy for pheochromocytoma is more difficult compared to other adrenal tumors

• Published in: Wideochirurgia i inne techniki mało inwazyjne Vol. 10; no. 3; pp. 466 - 471
• Main Authors: Natkaniec, Michał, Pędziwiatr, Michał, Wierdak, Mateusz, Białas, Magdalena, Major, Piotr, Matłok, Maciej, Budzyński, Piotr, Dworak, Jadwiga, Buziak-Bereza, Monika, Budzyński, Andrzej
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01-09-2015
• Subjects: Original Paper; adrenal tumor; pheochromocytoma; laparoscopic surgery; safety
• ISSN: 1895-4588; 2299-0054; 2299-0054
• DOI: 10.5114/wiitm.2015.52869

Laparoscopic adrenalectomy is the gold standard for the treatment of benign adrenal tumors. However, some authors raise the problem of differences in surgery for pheochromocytoma in comparison to other lesions.
To compare laparoscopic adrenalectomy for pheochromocytoma and for other tumors.
Four hundred and thirty-seven patients with adrenal tumors were included in the retrospective analysis. Patients were divided into two groups: 1 (124 patients treated for pheochromocytoma) and 2 (313 patients with other types of tumor). The two groups were compared with respect to mean operative time, intraoperative blood loss, conversion rate, complication rate and the relationship of tumor size with operative time.
The mean operative time in group 1 was 91 min, and in group 2 it was 82 min (p = 0.016). In both groups 1 and 2, tumor size correlated with operative time (p < 0.0001 and p = 0.0003, respectively). The mean blood loss in groups 1 and 2 was 117 ml and 54 ml, respectively (p = 0.0011). The complication rate in groups 1 and 2 was 4% and 4.2%, respectively (p = 0.9542). In groups 1 and 2, conversion was necessary in 2 (1.6%) and 5 (1.6%) cases, respectively (p = 0.9925).
Longer operative time and higher blood loss after laparoscopic adrenalectomy for pheochromocytoma indicate its greater difficulty. However, despite these drawbacks, minimally invasive surgery still seems to be an effective and safe method.