Laparoscopic compared with open adrenalectomy for resection of pheochromocytoma: a review of 47 cases.

OBJECTIVE We conducted a retrospective cohort study to determine whether laparoscopic adrenalectomy (LA) is a safe and effective therapy for the management of pheochromocytoma, as compared with open adrenalectomy (OA). METHODS We collected pertinent data on 47 pheochromocytoma resections from 44 patient charts. Perioperative outcomes of 30 LAs were compared with 14 OAs. RESULTS Median (and standard deviation [SD]) length of postoperative stay was shorter in the laparoscopic group (3.0, SD 3.3 d v. 6.0, SD 1.1 d; p < 0.05), and tumour size was smaller (3.9, SD 2.7 cm v. 5.0, SD 2.9 cm; p < 0.05). No statistically significant differences were found for operative time or rate of postoperative complications. There were no statistically significant between-group differences in intraoperative hypertensive episodes (systolic blood pressure > 180 and/or diastolic blood pressure > 90) or hypotensive episodes (systolic blood pressure < 100 and/or diastolic blood pressure < 60) or in the need for antihypertensive or vasopressive agents. There were no intraoperative complications related to extremes of blood pressure. There were no perioperative mortalities in this series, nor was there an increased risk of recurrent disease with the laparoscopic technique. CONCLUSION LA is safe and effective for the management of pheochromocytoma.