Advantages and complications of laparoscopic adrenalectomy

We conducted a retrospective analysis of medical records of 53 patients with the tumors of the adrenal glands. 30 patients, including 4 with pheochromocytoma, were treated by laparoscopic adrenalectomy, 23 - treated by traditional access. We confirmed the advantages of the laparoscopic technique and showed the reduction of postoperative pain by 1.7 points according to the 10-point scale, the need for the appointment of analgesics, the decreased number of postoperative complications by 18,4% and hospital stay by 5,9 days. We also compared the results of the laparoscopic and “open” adrenalectomy for the tumors of the chromaffin tissue. It was found out that the volatility of changes of intra - and postoperative hemodynamic depended on the clinics, hormonal activity and size of the tumor, orthostatic test, preoperative treatment and surgical access. It was revealed that significant intraoperative hemodynamic fluctuations occured in 78.1% of patients operated on for chromaffinoma. The pressure fluctuations were highest in patients with "classic" clinical course of pheochromocytoma, preoperative elevation of catecholamines or metanephrines in laboratory tests, with a positive orthostatic breakdown test, treated with preoperative preparation and operated by "traditional" approach.