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Laparoscopic Surgery Offers Benefits for Adrenal Tumors

Superior results seen in retroperitoneoscopic lateral adrenalectomy compared to open approach in patients with pheochromocytoma

WEDNESDAY, Jan. 2 (HealthDay News) -- Retroperitoneoscopic lateral adrenalectomy is a safe and effective alternative to open surgery for treatment of pheochromocytoma, according to research published in the January issue of the Journal of Urology.

Bin Lang, of the First Affiliated Hospital of Xinjiang Medical University in Urumqi, China, and colleagues compared clinical data on 50 patients who underwent open surgery for pheochromocytoma with 56 who underwent retroperitoneoscopic lateral adrenalectomy. Some earlier research has discouraged laparoscopic approaches in these cases due to the cardiovascular risk of catecholamine secretion while manipulating the tumor.

In this study, retroperitoneoscopic lateral adrenalectomy was associated with shorter operative time, less estimated blood loss, shorter postoperative hospital stay, less incidence of intraoperative hypertension, fewer patients requiring blood transfusion and lower incidence of systemic inflammatory response syndrome.

The author of an accompanying editorial, Marcin Barczynski, M.D., of the Jagiellonian University College of Medicine in Krakow, Poland, writes about the retroperitoneoscopic approach, "Operations on tumors larger than 6 cm are highly demanding and they should be performed only by experienced surgeons and only in cases of a clear absence of any signs of malignancy, which occur anyway in 10 percent of pheochromocytoma tumors. We should always keep in mind that any rupture of the tumor capsule during surgery should be avoided to prevent local recurrence and dissemination in cases of unsuspected malignancy."

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