Retroperitoneal laparoscopy rather than an open procedure for resection of pheochromocytomas could minimize intraoperative blood pressure fluctuations and transfusion events.

摘要

OBJECTIVES: We retrospectively reviewed the outcomes after laparoscopy versus an open procedure for the resection of pheochromocytoma. PATIENTS AND METHODS: Forty-nine patients were enrolled into the study between June 2004 and December 2008 having been diagnosed with pheochromocytoma. The selection criteria were patients who were diagnosed with pheochromocytoma on admission based on clinical manifestations, imaging examinations and laboratory tests. Twenty-six patients underwent a retroperitoneal laparoscopic resection of their pheochromocytoma (LRP), and another 23 patients underwent an open resection of the pheochromocytoma (ORP). RESULTS: The ORP was similar to the LRP on the incidence of intraoperative blood pressure fluctuation. While compared to ORP, the process of LRP could effectively control the degree of fluctuations in intraoperative blood pressure(P < 0.05). Patients who received LRP had a significantly reduced volume of fluid in their drain on the first postoperative day than those who received ORP(P < 0.05), and due to the drain being removed sooner, they were consequently able to mobilize earlier(P < 0.05). The LRP cohort consisted of four patients with tumors ranging from 6 to 7 cm and three of them were successfully achieved. Intraoperatively or within 24 h postoperatively, 10 out of 23 patients who had undergone ORP received a transfusion, while none of those in the LRP cohort received a transfusion. CONCLUSIONS: Retroperitoneal LRP allowed patients to mobilize earlier and minimized the occurrence of intraoperative blood pressure fluctuations and transfusion events. Adequate preoperative preparation and skilled laparoscopic manipulation appeared to guarantee the safety of the procedure, and large tumors did not absolutely contraindicate the use of laparoscopy.