DOES HORMONAL FUNCTION OF THE TUMOR INFLUENCE THE OUTCOME OF LAPAROSCOPIC ADRENALECTOMY

Background: Patients with hypertension, with catecholamine hypersecret ion, and with cortisol excess may associate intraoperative cardiovascu lar instability and postoperative complications. Methods: To compare t he outcome of laparoscopic adrenalectomy (LpA) in patients with aldost erone adenoma (11), Gushing's adenoma (six), Gushing's disease (four), pheochromocytoma (Pheo) (11), and nonfunctioning tumor (five). Intra- and postoperative parameters were studied and in patients with Pheo i ntraoperative catecholamine plasma levels were correlated with cardiov ascular derangements. Results: Operative time, estimated blood loss, h ospital stay, analgesic requirements, and time to return to normal act ivity were significantly higher in patients undergoing total bilateral adrenalectomy for Gushing's syndrome compared with other groups under going unilateral adrenalectomy, but these latter groups showed no sign ificant differences among themselves in all parameters analyzed. One p atient with nonfunctioning tumor and another with Gushing's adenoma we re converted to open surgery, and two patients with Gushing's disease had urinary infection. Isolation of Pheo was associated with significa nt release of catecholamines but not with hemodynamic changes. Conclus ion: LpA may be the most suitable method for removing functioning adre nal tumors.