Experience With Retroperitoneal Laparoscopic Adrenalectomy for Pheochromocytoma

Salomon, Laurent; Rabii, R.; Soulié, M.; Mouly, Patrick; Hoznek, Andràs; Cicco, Antony; Saint, F.; Alame, Walid; Antiphon, Patrick; Chopin, Dominique; Plante, Pierre; Abbou, Clément‐Claude

doi:10.1016/s0022-5347(05)66231-3

Cited by 66 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 Early adrenal vein ligation before tumor manipulation is beneficial in patients with PCC to reduce the risk of excessive catecholamine secretion and cardiovascular complications. 11,23 Based on the present results, the large tumor group showed a longer operating time and greater quantities of blood loss with significant changes in hemoglobin levels compared with those belonging to the small tumor group. However, it should be noted that most of the patients in the large tumor group (75%) underwent the operation in the first half of the enrollment period.…”

Section: Discussionmentioning

confidence: 55%

“…We ligated the adrenal vein early in the procedure and reduced manipulation of the adrenal mass to avoid the risk of excessive catecholamine secretion and tumor disruption. 11 During the right adrenalectomy, the inferomedial surface of the adrenal gland was dissected off the renal vein and the inferior vena cava along with the dissection of the lateral and superior surfaces. During the left adrenalectomy, dissection and caudal retraction of the left renal artery helped in identifying the adrenal vein.…”

Section: Operative Proceduresmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?

Chung

Kim

et al. 2018

Int J of Urology

View full text Add to dashboard Cite

Objectives: To evaluate the surgical feasibility of laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of large pheochromocytomas, and to identify the preoperative risk factors for intraoperative hypertension. Methods: We retrospectively reviewed 51 patients who underwent laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of pheochromocytomas. Patient characteristics and perioperative outcomes were analyzed and compared between the two study groups based on tumor size: group A (n = 27, ≤6 cm) and group B (n = 24, ˃6 cm). Results: There was no significant difference in preoperative characteristics between the two groups except for tumor size (P = 0.001) and urinary metanephrine (P = 0.011). Group B patients required longer operating time (P = 0.008), had a greater estimated blood loss (P = 0.001) and hemoglobin change (P = 0.002). However, no significant differences were observed in perioperative complications and mortality. Multivariate analysis showed that symptomatic pheochromocytomas (P = 0.004) and tumor size (P = 0.007) were significant risk factors for intraoperative hypertension. Conclusions: Laparoscopic adrenalectomy using the lateral retroperitoneal approach for pheochromocytomas can be regarded as a treatment option, even for tumors measuring >6 cm. Symptomatic pheochromocytomas and large tumor size seem to represent risk factors for intraoperative hypertension.

show abstract

Section: Discussionmentioning

confidence: 55%

Section: Operative Proceduresmentioning

confidence: 99%

Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?

Chung

Kim

et al. 2018

Int J of Urology

View full text Add to dashboard Cite

show abstract

“…The retroperitoneal flank approach was easier than the retroperitoneal posterior approach. Gasman et al [11] reported that the retroperitoneal flank approach is safe and effective; Solomon et al [13] reported that the space created was large enough to insert four or five trocars, and that approaching the adrenal vein via the retroperitoneal flank approach was relatively easy. The retroperitoneal flank approach is now one of the alternative procedures for adrenal laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy: comparison of transperitoneal and retroperitoneal approaches

Naya¹,

Nagata²,

Ichikawa

et al. 2002

BJU International

View full text Add to dashboard Cite

Of the 50 patients, 31 had primary aldosteronism, eight had Cushing's syndrome, three had phaeochromocytoma, one had an 18-hydroxydeoxycorticosterone-induced adenoma and seven had non-functioning adrenal adenoma. Adrenal tumours were confirmed by hormonal assays, biochemical tests and computed tomography. To determine the site of the functioning adenoma, hormones were assayed from adrenal vein sampling. Thirty adrenal tumours were located on the right and 20 on the left. Results There were no significant differences in general demographic variables between the transperitoneal and retroperitoneal groups. The mean duration of surgery for transperitoneal and retroperitoneal laparoscopy was 202 and 221 min, respectively, and the mean blood loss 113 and 192 mL, respectively. The time to first oral intake, days to full diet, time until ambulatory and duration of hospitalization did not differ significantly between the two approaches. As the body mass index increased, the duration of surgery increased for both approaches. As more procedures were performed the duration of surgery decreased for both approaches. Conclusions There were no significant differences between the transperitoneal and retroperitoneal approaches for laparoscopic adrenalectomy.

show abstract

“…4 Traditionally, early AV ligation has been recommended for the laparoscopic adrenalectomy of PCC to reduce the release of excessive catecholamines. 5,6 However, favorable results have been reported in laparoscopic adrenalectomy, where the adrenal tumor was dissected without previous ligation of the AV. Zhang et al speculated that fine accurate manipulation of the tumor without direct pushing or grasping-the "no-touch technique"-could be safely performed before the ligation of the AV.…”

Section: Discussionmentioning

confidence: 99%

Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports

et al. 2018

View full text Add to dashboard Cite

Introduction Surgical manipulation of a pheochromocytoma carries the risk of releasing catecholamines into bloodstream leading to severe intraoperative hypertension. Case presentation We present three patients with right adrenal pheochromocytoma over 10 cm diameter: a 40‐year‐old woman, 63‐year‐old man, and 66‐year‐old woman. They were diagnosed by 123I‐MIBG scintigraphy and received preoperative antihypertensive treatment with 16 mg/day of doxazosin. Open adrenalectomy was performed with early right adrenal artery ligation between the inferior vena cava and ventral aorta (Step 1) as well as between the tumor and upper pole of the right kidney (Step 2). There was no severe intraoperative hypertension, and no recurrence was observed over 33 months, postoperatively. Conclusion Early adrenal artery ligation may stop tumor blood supply and significantly reduce the catecholamine release. Our technique was thought to be safe and useful for preventing severe intraoperative hypertension in giant right adrenal pheochromocytoma.

show abstract

Experience With Retroperitoneal Laparoscopic Adrenalectomy for Pheochromocytoma

Cited by 66 publications

References 20 publications

Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?

Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?

Laparoscopic adrenalectomy: comparison of transperitoneal and retroperitoneal approaches

Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports

Contact Info

Product

Resources

About