Background: Laparoscopic adrenalectomy became in past decade the procedure of choice for adrenal pathology and now is adopted for larger tumors or even large pheochomocytomas.
Method: Since 2003 in General Surgery Department Emergency Hospital Bucharest Romania, the same surgical-anaestesical team performed over 150 adrenalectomies and 9 of this procedure were for pheochromocytomas larger then 6 cm. All patients were diagnosticated in National Institute of Endocrinology C. I . Parhon and prepared preoperative with alpha-blocker for 10-14 days.
Results: We studied retrospectively 9 patients with pheochromocytomas larger then 6 cm, 6 female and 3 male with age between 20-72 years old (49,11), 6 on the left side, 2 on the right side and 1 bilateral. Antero-lateral transperitoneal laparoscopic approach was performed. Mean operating time was 116,6 min (70-220min for the bilateral approach) and mean hospital postoperative stay was 5,22 days (2-8 days). Conversion to open procedure was performed in 4 cases (2 left and 2 right)due tobleeding, adhesion to renal vein, vena cavaintraoperative injury and a tumor bigger than 12 cm. Mass diameter was between 7 and 14 cm. No postoperative complications and no mortality were recorded.
Conclusions: Laparoscopic adrenalectomy is a safe procedure, even for large pheochromocytomas (over 6 cm) along with a surgical-anaestesical team trained in advanced laparoscopic surgery.
Program Number: P500