LAPAROSCOPIC SURGERY FOR PHEOCHROMOCYTOMA - ADRENALECTOMY, PARTIAL RESECTION, EXCISION OF PARAGANGLIOMAS

Purpose: Surgical treatment of pheochromocytoma includes adrenalectomy , adrenal sparing surgery and excision of extraadrenal paragangliomas. We report our experience using laparoscopy for these procedures. Mate rials and Methods: Between June 1992 and November 1997, 19 patients un derwent laparoscopic surgery for pheochromocytoma. Of the patients 14 had solitary tumors, and 4 presented with bilateral pheochromocytomas and 1 or 2 additional paragangliomas. In 1 patient a recurrent pheochr omocytoma was found in the contralateral adrenal following previous ri ght adrenalectomy. One patient each had myocardiopathy, amaurosis and stroke secondary to severe hypertension. Two patients were pregnant. R esults: All solitary tumors were treated with laparoscopic adrenalecto my. Laparoscopic adrenal sparing surgery (4 cases, 2 bilateral) and bi lateral adrenalectomy (1) were performed for multiple familial pheochr omocytoma, and all paragangliomas were excised simultaneously. The pre gnant patients underwent surgery at 16 and 20 weeks of gestation, resp ectively. All procedures were completed as planned. The rate of minor intraoperative and postoperative complications was 11% and 16%, respec tively, and there were no major complications. In all patients the cat echolamine levels returned to normal and no residual tumors were found at followup. None of the patients undergoing partial resection requir ed steroid replacement therapy. Conclusions: In experienced hands, lap aroscopic surgery for solitary and multiple pheochromocytoma and parag anglioma is feasible and safe, and does not increase the specific risk s associated with pheochromocytoma surgery.