Laparoscopic adrenalectomy for pheochromocytoma

被引:73
作者
Cheah, WK
Clark, OH
Horn, JK
Siperstein, AE
Duh, QY
机构
[1] Univ Calif San Francisco, Vet Affairs Med Ctr, Dept Surg, San Francisco, CA 94121 USA
[2] Univ Calif San Francisco, Mt Zion Med Ctr, Dept Surg, San Francisco, CA 94115 USA
[3] San Francisco Gen Med Ctr, Dept Surg, San Francisco, CA 94110 USA
关键词
D O I
10.1007/s00268-002-6669-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Laparoscopic adrenalectomy is the standard for most surgical adrenal diseases. The aim of this study was to evaluate the safety and effectiveness of laparoscopic adrenalectomy for patients with pheochromocytoma. The medical records of 39 consecutive patients who underwent laparoscopic adrenalectomy for pheochromocytomas from 1994 to 2000 at the University of California-San Francisco were reviewed. Three groups of patients were identified. The first group comprised 17 patients with classic symptoms and signs of pheochromocytoma. The second group comprised 17 patients who had minimal symptoms and incidentally discovered pheochromocytoma (i.e., "incidentaloma"), almost half of whom inappropriately underwent fine-needle biopsies before diagnosis. The third group consisted of 5 patients who had acute hypertensive crises and required intensive preoperative preparation. The mean age of the 22 men and 17 women was 46 years (range 20-84 years), and the mean adrenal tumor size was 4.8 cm (range 2-12 cm). A total of 43 laparoscopic adrenalectomies were performed for 35 patients with unilateral tumors and 4 patients with bilateral tumors. The retroperitoneal approach was used in four patients and the lateral transabdominal approach in the remaining patients without conversion to an open operation. There were no intraoperative complications or mortality. The mean duration of hospitalization was 1.7 days. In conclusion, patients with pheochromocytoma have a wide spectrum of presentations, from minimal symptoms to hypertensive crises. When evaluating an incidentaloma, pheochromocytoma should be excluded by metabolic testing, not by needle biopsy. Laparoscopic adrenalectomy is the preferred surgical approach for patients with pheochromocytoma because it is safe and efficacious.
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页码:1048 / 1051
页数:4
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