caa a22 4500 477035442 CHVBK 20180405111304.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002689900116 doi (NATIONALLICENCE)springer-10.1007/s002689900116 Laparoscopic Approach to Pheochromocytoma: Hemodynamic Changes and Catecholamine Secretion [Elektronische Daten] [Laureano Fernández-Cruz, Pilar Taurá, Alejandro Sáenz, Guerson Benarroch, Luis Sabater] Abstract. This study compares the outcome of laparoscopic adrenalectomy (LpA) in 23 patients using CO2 insufflation with the outcome of this procedure in another 8 patients with pheochromocytoma (7 unilateral, 1 bilateral) using helium for pneumoperitoneum. The adrenal lesions in the first group included nonfunctional adenoma (: n = 3), aldosterone adenoma ( n = 11), Cushing's adenoma ( n = 6), and Cushing's disease ( n = 3). The latter patients were compared with a third group of 8 patients with pheochromocytoma undergoing conventional transabdominal adrenalectomy (CTA). With both procedures, intraoperative changes in plasma catecholamine levels were studied during pheochromocytoma removal and the changes correlated with intraoperative cardiovascular derangements. LpA was successfully performed in 95% of patients with adrenal lesions and in 100% of patients with pheochromocytoma. There was no significant difference in laparoscopic adrenalectomy for pheochromocytoma compared to that for other adrenal lesions in terms of operative time, blood loss, hospital stay, analgesic requirements, and return to normal activity. The outcome was less favorable in pheochromocytoma patients undergoing CTA. The largest increase of catecholamine levels in pheochromocytoma patients occurred during tumor manipulation with both LpA (17.4-fold for epinephrine and 8.6-fold for norepinephrine) and CTA (34.2-fold for epinephrine and 13.7-fold for norepinephrine), but cardiovascular instability was associated only with CTA. LpA may become the technique of choice for surgical removal of adrenal lesions and may also become the preferred method for removing pheochromocytoma. 1996 by the Société Internationale de Chir, ugie Fernández-Cruz Laureano Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut Taurá Pilar Department of Anesthesiology, Hospital Clinic, University of Barcelona, C/ Villarroel, 170, 08036 Barcelona, Spain, ES aut Sáenz Alejandro Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut Benarroch Guerson Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut Sabater Luis Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut https://doi.org/10.1007/s002689900116 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900116 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fernández-Cruz Laureano Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Taurá Pilar Department of Anesthesiology, Hospital Clinic, University of Barcelona, C/ Villarroel, 170, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Sáenz Alejandro Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Benarroch Guerson Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Sabater Luis Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain, ES aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer