LAPAROSCOPIC ADRENALECTOMY IN ASYMPTOMATIC PHEOCHROMOCYTOMA

A patient with asymptomatic pheochromocytoma associated with catechola mine hypersecretion but no hypertension was treated by right laparosco pic adrenalectomy. The 63-year-old male patient was referred to us for treatment of an incidentaloma, The diameter of the adrenal tumor was 50 mm, and the peripheral blood norepinephrine level was 1.12 ng/ml (n ormal level, 0.4 ng/ml). Blood pressure was normal. A flexible electro n laparoscope was used for open laparoscopy, and four trocars were ins erted. The retroperitoneum was incised to the right of the inferior ve na cava, and the tumor was excised. During the operation, blood pressu re rose transiently, and a blocker and nitroglycerin were administered . The tumor bled extremely easily. The duration of surgery was 3 hours and 20 minutes, and blood loss was 210 ml, The excised tumor was 55 m m in diameter. The patients's postoperative course was uneventful, If the size of asymptomatic pheochromocytoma is not large, and blood pres sure and cardiac function are stable laparoscopic adrenalectomy is ind icated for this type of tumor as long as it is performed by experience d surgeons.