副腎褐色細胞腫に対する腹腔鏡下副腎摘除術の検討

Abstract

The relationship between surgical methods andclinical parameters was analyzedretrospectively in 32 patients operatedfor adrenal pheochromocytoma (laparoscopic surgery, 13 patients ; open surgery, 19 patients) in Jikei University Hospital from 1997 to 2006. The mean tumor size was higher in open surgery patients. Preoperative hypertension was recordedin 7 open surgery patients and15 laparoscopic surgery patients ; 5 and16 patients, respectively, were administeredan α1-blocker preoperatively. Despite only slight differences in background data, blood loss was significantly less in the laparoscopic surgery patients than in the open surgery patients. However, intraoperative variation in bloodpressure was greater in the former, probably because of technical difficulties or inadequate preoperative management. The duration of operation was not significantly different between the 2 groups. Tumor size did not show a significant correlation with either duration of surgery or blood loss. On the other hand, a significant correlation was notedbetween bloodloss andd uration of surgery only in open surgery patients. Postoperative recovery time was significantly shorter in laparoscopic surgery patients. After considering factors such as tumor size, hormone activity, preoperative management, andsurgeon's skill, we believe that comparedto open surgery, laparoscopic surgery is a less invasive andmore useful methodfor adrenal pheochromocytoma.