Catecholamine and cytokine response to laparoscopic adrenalectomy in patients with pheochromocytoma

This study assesses the surgical stress of laparoscopic adrenalectomy (LA) in patients with pheochromocytoma using catecholamine and cytokine. The stu dy was conducted on one patient who had laparoscopic adrenalectomy performe d for pheochromocytoma, and three patients as controls who had undergone la paroscopic cholecystectomy (LC) for cholecystolithiasis. Catecholamines, tu mor necrosis factor alpha (TNF alpha) and interleukin 6 (IL-6) were measure d at 30-minute intervals intraoperatively, and on the first, third and fift h postoperative days (POD) respectively. Plasma TNFa and IL-6 were measured by a commercially available sandwich enzyme-linked immunosorbent assay tes t. During the operation, changes of catecholamine concentration in LA were far larger than those in LC. The changes of TNF alpha concentration in LA w ere also larger than those in LC. TNF alpha returned to basal value at the end of the operation in LC, but it did not in LA. TNF alpha concentration i n LC changed a little after the surgery, whereas that in LA sharply increas ed and was maintained at a high level from 1 POD until 5 POD. Enhanced cyto kine responses were observed in LA compared to LC during and after the surg ery. We concluded that laparoscopic adrenalectomy may give those patients w ith pheochromocytoma more surgical stress than laparoscopic cholecystectomy for cholecystolithiasis, during and after the operation. (C) 2000 Editions scientifiques et medicales Elsevier SAS.