Retroperitoneoscopic excision of phaeochromocytoma - Haemodynamic events, complications and outcome

Over a period of 15 months, II patients with phaeochromocytoma underwent re troperitoneoscopic excision of their tumours. Five patients had bilateral t umours. All patients underwent thorough preoperative evaluation and prepara tion with alpha- and beta-blockade. In the majority of the patients a hyper tensive response was seen during generation of pneumoretroperitoneum. Howev er; the period of tumour dissection and excision was devoid of large haemod ynamic fluctuations. The average time taken was 3.5 to 4 hours per gland Bl ood loss in successful laparoscopic excision averaged 240 mi (range 120 to 700 ml). In these patients satisfactory postoperative analgesia could be pr ovided with intramuscular pethidine or intramuscular diclofenac sodium, In three patients the procedure had to be converted to open laparotomy due to haemorrhage. All three patients had preoperative radiological evidence of i nferior vena cava and aortic involvement. Patient selection plays an import ant role in a successful outcome.