Prikaz slučaja prve laparoskopske adrenalektomije kod feohromocitoma u Kliničkom centru Srbije

Abstract

Introduction Endoscopic surgery progressed and developed significantly during the last two decades and laparoscopic adrenalectomy is now considered as the treatment of choice for pheochromocytoma. Still, this procedure can be associated with high incidence of intraoperative hypertension. We present a case of the first laparoscopic adrenalectomy for pheochromocytoma in Serbia. Case Outline A 55-year-old female was admitted to Center for surgery for pheochromocytoma of the left adrenal gland. Clinically patient acquires classical manifestation of pheochromocytoma (hypertension, palpitations, tachycardia and pain below the left rib cage). CT and MR revealed necrotic-cystic oval formation of the left adrenal gland, 50x48x48mm in diameter. The pre-operative preparation was with phenoxybenzamine, ACE inhibitors and rehydratation prior the surgery. Left laparoscopic adrenalectomy was performed with 3 ports (two 10-mm and one 5-mm ports). The anesthesia lasted 155 minutes and the operation 125 minutes. Regarding the blood pressure there were no hypertension crises during the surgery. The patient was discharged on the 3rd postoperative day to our endocrinology department, and during stay in our institution the patient was normotensive. Conclusion Laparoscopic adrenalectomy is the safe and effective surgical method for pheochromocytoma surgery.