Laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma

Biteman, Benjamin; Randall, James A; Brody, Fred

doi:10.1007/s00464-016-4919-5

Cited by 13 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, adrenal-sparing surgeries (one-sided or bilateral) are performed in patients at high risk of developing a second tumour in the opposite adrenal gland with a predicted mild course of the disease. These criteria are met in RET, VHL, and NF1 mutation carriers [11,14,15].…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic cortical-sparing adrenal surgery in pheochromocytomas associated with hereditary neoplasia syndromes

Hasse-Lazar

Zeman

Kotecka-Blicharz

et al. 2020

Endokrynologia Polska

View full text Add to dashboard Cite

Introduction: Pheochromocytomas in hereditary syndromes tend to grow multifocal with adrenal involvement on both sides. Surgical treatment with bilateral adrenalectomy inevitably leads to life-long hormonal dependence, which significantly affects quality of life. The development of minimally invasive adrenal surgery has created a chance to preserve adrenal cortex function in these patients. The aim of the present study was to evaluate the safety of laparoscopic cortical-sparing adrenal surgeries and their efficacy in the prevention of postoperative adrenal insufficiency in patients with hereditary pheochromocytomas. Material and methods: We retrospectively analysed the medical histories of 10 patients, who underwent 10 laparoscopic cortical sparing adrenal surgeries from January 2015 to January 2019 in our centre. The decision to perform sparing surgery was based on preoperative diagnosis of hereditary syndrome in line with the result of DNA analysis or its diagnosis based on the clinical appearance. All surgeries were performed laparoscopically from transperitoneal access in the lateral decubitus position, with preserving 1/3-1/4 adrenal tissue. The sufficiency of remnant adrenal tissue was assessed in all patients. The median time of follow-up was three years (ranged 0.5-4 years). Results: No intraoperative complications were observed. One case of acute heart failure was the only early postoperative adverse event. There were no late postoperative complications and no local recurrences observed. In one out of three patients undergoing sparing surgery as a second procedure after former total adrenalectomy, adrenal cortex failure occurred. In all patients after unilateral surgery or after bilateral surgery performed simultaneously (total adrenalectomy at one side and sparing surgery contralaterally), function of remnant adrenal tissue was preserved. Conclusions: In hereditary pheochromocytomas, with minimal risk of malignant process, laparoscopic cortical sparing adrenal surgeries are the safe approach and provide the chance to preserve adrenal cortex function.

show abstract

Section: Methodsmentioning

confidence: 99%

Laparoscopic cortical-sparing adrenal surgery in pheochromocytomas associated with hereditary neoplasia syndromes

Hasse-Lazar

Zeman

Kotecka-Blicharz

et al. 2020

Endokrynologia Polska

View full text Add to dashboard Cite

show abstract

“…Any bloody source can Surgical Approach in Pheochromocytoma DOI: http://dx.doi.org/10.5772/intechopen.96066 be solved by IVC partial clamping only if it is exposed and have a good control. It is mandatory for a safe treatment of the vascular pedicles and for the achievement of complete glandular removal to have a complete exposure of the entire medial and superior margin of the gland [4,5].…”

Section: Laparoscopic Technique 41 Elements Of Surgical Technique Anmentioning

confidence: 99%

“…The remaining glands may lose function, and the patient may benefit from total adrenalectomy to avoid the need for reoperation of relapse. After the tumor is removed, put the specimen in the bag and take it out [4][5][6][7].…”

Section: Laparoscopic Technique 41 Elements Of Surgical Technique Anmentioning

confidence: 99%

“…Postoperatively, the majority of patients that had an uneventful intraoperative course with or without hemodynamic instability do not necessitate intensive care supervision. In the first postoperative period, the patients that have pheochromocytoma have also a greater risk of hypoglycemia and hypotension [5]. After catecholamines are suddenly stopped, due to the relative increase in insulin sensitivity, hypoglecemia may occur.…”

Section: Perioperative/postoperative Managementmentioning

confidence: 99%

“…The USA has a pheochromocytoma's annual incidence of 500-1,600 cases per year with equality between genders and a peak incidence in the forth decade of life. The association with hypertension is well known; in the case of patients with hypertension, it is encountered with an incidence of 0.1-0.6% [5]. The classical mode of presentation of a pheochromocytomas case consists of headaches, diaphoresis, flushing and paroxistic hypertension [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Approach in Pheochromocytoma

Mirică¹,

Păun²

2021

Pheochromocytoma, Paraganglioma and Neuroblastoma

View full text Add to dashboard Cite

Pheochromocytomas are tumors composed of chromaffin cells that can produce, secrete and metabolise catecholamines. The surgical excision procedure of these tumors may present the risk of significant variations in blood pressure, as well as the chance of cardiovascular complications in the perioperative period. During surgery, patients may be at risk for cardiovascular events such as major variations in blood pressure, pulmonary edema, stroke, myocardial infraction and a long period of intubation. The surgical approach to pheochromocytomas must always be preceded by accurate imaging evaluation, endocrine screening and identification of associated genetic mutations. In addition, the surgical technique of choice consists in using minimally invasive surgical methods, with a transabdominal or retroperitoneal approach.

show abstract