Clinical study of 3D laparoscopic surgery for adrenal pheochromocytoma / paraganglioma

Abstract

Objective To investigate the efficacy and safety of 3D–laparoscopic surgery in adrenal pheochromocytomas /paragangliomas. Methods From December 2012 to July 2014, 23 cases of adrenal pheochromocytomas /paragangliomas were treated by 3D–laparoscopic surgery. Among them, 7 cases were male and 16 cases were female, whose mean age are 47(32–68) years old . Their clinical symptoms including sustained hypertension in 11 cases, intermittent hypertension in 8 cases, sustained hypertension with intermittent progression in 2 cases and asymptom in 2 cases. All tumors were diagnosed by endocrine examination, image test and nuclear medicine. Mean diameter of tumors are 8 cm, ranged from 3–14cm.In order to adjust the blood pressure, patients took α–receptor blocker for 2–4 weeks preoperatively. Under the general anesthesia, 19 patients received the 3D–laparoscopic surgery via retroperitoneal approach and 4 cases received the procedure via peritoneal approach. Results All operations were completed successfully. There were no major intraoperative complications. Mean operating time was (78±21)min and mean estimated blood loss was(54.8±36.3)ml.Mean hospital stay after operation was(3.8±1.4)days. The pathological diagnosis included pheochromocytomas in 15 cases and paragangliomas in 8 cases. During the 3 to 18 months following up, no recurrence or metastasis was found in this study. Conclusions 3D–laparoscopic surgery has obvious advantage in spatial location and the sense of depth for adrenal pheochromocytomas /paragangliomas, which shortens the operation time and increase the safety obviously. Key words: Three–dimensional imaging laparoscopy; Surgery; Adrenal tumor; Pheochromocytoma; Paraganglioma