Objective: To evaluate the correlation between tumour diameter and intraoperative haemodynamic variations during adrenalectomy based on a series of 15 operated cases of adrenal phaeochromocytoma.
Material and methods: Seventeen adrenalectomies for adrenal phaeochromocytomas were performed between January 1997 and March 2007. Two laparoscopic adrenalectomies were excluded to ensure a homogeneous series. The mean age of the patients was 39 years (range: 29-75). The hypertensive peak was defined according to the recommendations of the European Society of Hypertension (blood pressure greater than 140/90mmHg). Intraoperative blood pressure was measured and recorded every 10minutes during the operation.
Results: The median diameter of unilateral tumours was 6cm (range: 3-11) and the median diameter of bilateral tumours (two cases) was less than 6cm. The mean operating time was 135minutes (range: 120-170) for tumours greater than or equal to 6cm versus 105minutes (range: 90-145) for tumours less than 6cm. Operating time was increased by an average of 30minutes for tumours greater than or equal to 6cm. Hypertensive peaks were recorded in seven out of eight cases (87.5%) for adrenal phaeochromocytomas greater than or equal to 6cm, and in three out of seven cases (29%) for adrenal phaeochromocytomas less than 6cm (P=0.04).
Conclusion: Tumour diameter is a decisive predictive factor of intraoperative haemodynamic variations in adrenal phaeochromocytoma surgery.