Abstract：Objective:To evaluate the efficancy and safety of transperitoneal laparoscopic adrenalectomy for large pheochromocytoma (with diameter greater than 6 cm). Methods:A restrospective analysis was performed on 21 patients who underwent laparoscopic adrenalectomy for large pheochromocytoma. All patients were prepared by 20-60 mg dose of phenoxybenzamine per day for 2 to 4 weeks before the surgery. Results:The mean age was (47.8±11.5) years (range 27-66). There were 14 cases of lesions located in left side and 7 cases in opposite. The mean diameter was (8.5±2.3) cm (range: 6.3-14.5 cm). All cases were treated with transperitoneal laparoscopic adrenalectomy and two of them were converted to open operation due to adhesion to liver and inferior vena cava. The mean surgical time was (160.7±33.2) min (range: 115 to 230 min). The volume of hemorrhage was (124.1±71.5) mL (range: 70 to 360 mL). For two open cases, surgical time were 260 and 300 min ,and the volumn of hemorrhage were 800 and 1 000 mL respectively. The mean hospital stay after operation was (8.2±0.9) days (range: 7 to 10 days), and no major intraoperative complications occured. All cases were follewed up for 6 to 60 months, and one patient was recurred with abdomen metastasis and died in 13 months after operation. Conclusions:With adequately preoperative preparation and carefully intraoperative manipulation, transperitoneal laparoscopic adrenalectomy could be a safe and minimally invasive procedure for large pheochromocytoma.
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