Effectiveness and safety of laparoscopic adrenalectomy of large pheochromocytoma: a prospective, nonrandomized, controlled study

Retroperitoneal laparoscopic adrenalectomy with transient renal artery occlusion for large adrenal tumors (≥8 cm)

“…independent predictive factor for overall complications, 19,20 but transient renal artery occlusion did not increase the rate of conversion to OA compared with LA or traditional RLA. Intraoperative hemodynamic instability is the primary safety concern when using LA for the resection of PCC, 21 but it occurred in only one patient in our study.…”

“…Furthermore, conversion to OA is an independent predictive factor for overall complications, but transient renal artery occlusion did not increase the rate of conversion to OA compared with LA or traditional RLA. Intraoperative hemodynamic instability is the primary safety concern when using LA for the resection of PCC, but it occurred in only one patient in our study. Some authors have suggested that the main limitation of laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with an increased risk of local recurrence and intra‐abdominal neoplastic dissemination; however, we found no evidence of metastasis or recurrence during the 7‐to‐30‐month follow‐up period.…”

Salvage Technique for Intraoperative Hemorrhage during Laparoscopic Resection of Large Pheochromocytoma: A Case Report and Literature Review

“…Average length of hospital stay is reported to be of 4 days for laparoscopic approach, compared to that of 9 days in the open group. 28,29 In our current case, patient was discharged home well on postoperative day 4. Hand-assisted adrenalectomy would therefore, still represent a significant advantage over the open technique.…”

Current perioperative management of pheochromocytomas

“…Many reports have tried to elucidate the factors which can affect the number and severity of these hypertensive episodes. [485253] Anesthetic drugs,[2338] tumor size[5254] and site,[55] associated genetic syndrome,[56] plasma catecholamine levels,[5257] and type of surgical approach[545558] may influence the intraoperative hemodynamic stability in these patients. Bleeding is another important concern especially during resection of PGL situated in the intra-aortocaval groove which may further confound the complex hemodynamic management of these patients.…”