Laparoscopic adrenalectomy for phaeochromocytoma: is it contraindicated?
Subhasis K Giri, Lee C Yap, Louise McLoughlin, Elaine J Redmond, Asadullah Aslam, and Hugh D Flood Fig 4.
University Hospital Limerick
Introduction
Laparoscopic adrenalectomy (LA) is becoming gold
standard for most surgical diseases of the adrenal gland.
However it has been suggested that catecholamine
effects associated with phaeochromocytoma render the
laparoscopic approach a more challenging and a more
morbid procedure. The purpose of this study was to
compare the outcomes of LA for phaeochromocytoma
and non-phaeochromocytoma.
Methods
The hospital records of all patients who underwent LA
(Fig 1 -4) between 2012 to March 2015 were
reviewed. The preoperative diagnosis was
documented, as well as the pathologic diagnosis,
operative details, complications, and length of hospital Fig 3.
stay.
B
A Fig 1. Adrenal vascular anatomy
Fig 2. Adrenal Phaechromocytoma ‐ MRI & CT
Results:
Total of 15 patients underwent LA. Three had
phaeochromocytoma, four aldosteronoma, one hamartoma,
one adrenal carcinoma, one angiomyolipoma and 5 had nonfunctioning adenoma. Mean operative blood loss between
phaeochromocytoma group and non-phaeochromocytoma
group were 120 and 100 ml respectively. The mean operative
time was 140 minutes for phaeochromocytoma
group and 120 min for non-phaeochromocytoma group. Mean
length of hospital stay was 3.4 versus 2.5 day. The differences
were not statistically significant. One patient in the nonphaeochromocytoma group was converted to open. There was
no Clavien grade 2 or more complications.
Conclusions:
Laparoscopic adrenalectomy is a safe technique with
excellent peri-operative outcome for most adrenal lesions,
including phaeochromocytomas.
C