Surgical treatment of pheochromocytomas - Laparoscopic or conventional?

Background: The use of minimally invasive techniques in the surgical treatm ent of pheochromocytoma is controversial because of possible intraoperative excessive hormone release resulting in cardiovascular instabilities. Methods: Laparoscopic adrenalectomy was performed in nine patients with a t otal of 10 pheochromocytomas. Conversion was required in two cases. The rel evant data were prospectively documented and compared with a historical gro up of nine patients who had undergone conventional transabdominal adrenalec tomy for unilateral pheochromocytoma. Results: The laparoscopic operations lasted significantly longer than the c onventional procedures (median 243 min vs. 100 min, p < 0.01). Intraoperati ve cardiovascular instabilities (tachycardia, hypertension) occurred in sev en laparoscopically and eight conventionally treated patients. All were eas ily controlled. Blood transfusions were necessary in four patients in the c onventional and one patient in the laparoscopic group. Postoperative hospit al stay and duration of analgetic treatment were significantly shorter afte r laparoscopic adrenalectomy. Conclusions: Laparoscopic adrenalectomy is a safe procedure for patients wi th pheochromocytoma.