Comparison Of Clinical Efficacy Between Retroperitoneal Laparoscopic Surgery And Open Adrenalectomy For Adrenal Pheochromocytoma

【Objective】:To evaluate the curative effects,indications and efficiency ofretroperitoneal laparoscopic excision of adrenal pheochromocytoma,and comparewith open operation,and then analyze it to supply more clinical reference for effectivetreatment of adrenal pheochromocytoma.【Methods】:A retrospective reviews of61patients in affiliated union hospital ofFujian Medical University was conducted,who were pathologically diagnosed withadrenal pheochromocytoma between January2006to December2012,among which31patients were treated by retroperitoneal lapaoarscopic excision(retroperitoneallapaoarscopic group),the rest by open operation(open group).Summarized therelevant information of above cases,the operation time,intraoperative bloodloss,intraoperative transfusion rate,intraoperative fluctuated blood pressurerate,drainage duration,frequency of using analgesic,complication rate,fasttime,hospital days,postoperative blood pressure return to normal rate, recurrencerate,these date of the two procedures were compared with statistieal analysis.【Results】:All operations were completed successfully,no death occurred and therewas no conversion to open surgery in retroperitoneal lpaoarscopic group.Laparoscopicgroup had shorter operative time[(134.8±66.4) min vs.(175.0±54.8) min,P=0.012];less intraoperative blood loss[(50/150-20) ml vs.(250/850-100) ml,P<0.001];lower intraoperative fluctuated blood pressure rate[12.9%(4/31) vs.40.0%(12/30),P=0.022];less intraoperative transfusion rate[12.9%(4/31) vs.50.0%(15/52), P=0.002];shorter fast time[(1.8±0.8) d vs.(2.3±0.6) d, P=0.015]；lessfrequency of using analgesic [(0.4±0.7) vs.(1.9±1.6), P=0.002];lower complicationrate[6.5%(2/31) vs.26.7%(8/30), P=0.033].No significant difference was found indrainage duration,follow-up time,postoperative blood pressure return to normalrate,recurrence rate between the two groups (P>0.05).【Conclusions】:For those experienced and skilled operators,comparing to open operation，retroperitoneal laparoscopic excision of adrenal pheochromocytoma has itsadvantages including less trauma,shorter operation time,less blood loss,quickerrecovery and so on,and the recent curative effect is comparable to open surgery.Retroperitoneal laparoscopic adrenalectomy for the adrenal pheochromocytomashould be considered as the first choice.