Posterior Retroperitoneoscopic Adrenalectomy is a Safe and Effective Alternative to Transabdominal Laparoscopic Adrenalectomy for Pheochromocytoma

Predictive factors for postoperative morbidity after laparoscopic adrenalectomy for pheochromocytoma: a multicenter retrospective analysis in 225 patients

“…This may be due to the larger sample size or the variability due to multiple clinicians performing this surgery at several institutions. Similar to prior reports, we observed that retroperitoneal approach was performed in patients with smaller tumors [20,25]. We also found that the type of medications used for preoperative management (alpha blockade vs. calcium channel blockade) and preinduction blood pressure normalization after preoperative medical preparation has no significant impact on postoperative morbidity rate [3,12,27].…”

“…Surgery for pheochromocytoma carries a risk of intraoperative hemodynamic instability [4,5,17]. Incidence of intraoperative hemodynamic instability episodes during laparoscopic adrenalectomy for pheochromocytoma ranged from 17 to 83 %, which correlates with the findings in our study [1,4,13,[19][20][21]. In early studies, life-threatening intraoperative catecholamine release had been quickly identified as the causes of blood pressure variability and various cardiac arrhythmias leading to perioperative morbidity and mortality [3,4,8,10].…”

“…Overall, similar to prior reports the morbidity of adrenalectomy for pheochromocytoma ranges from 0 to 1,5,13,19,20,[23][24][25][26]. Given the perioperative optimization of patients with these tumors, the mortality of this surgical approach reaches 0 %.…”

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

“…25 In the hands of experienced laparoscopic surgeons, LA can be used for the treatment of incidentally identified asymptotic small-sized PCCs in hemodynamically stable patients. 26 However, when LA is applied to larger sized adrenal tumors, there is a high risk of conversion to OA and of surgery-related morbidities. 27 To the best of our knowledge, this study represents the first prospective, controlled study comparing the effectiveness and safety of LA versus OA for the treatment of large-sized PCCs.…”

Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for large pheochromocytoma: Comparative outcomes

“…14,15 In other studies, the RPA has been shown to reduce the operative time, duration of hospitalization and postoperative pain. 16,17 A retrospective study including 99 pheochromocytomas and comparing the TPA and RPA showed that the mean operative time (117 vs 84 min), blood loss (340 vs 200 mL), hospital stay (7.8 vs 4.8 days) and complication rate were all significantly greater in the TPA group, showing the superiority of the RPA for small pheochromocytomas. 18 Regarding large pheochromocytoma, Chung et al reported that RPA was a safe and feasible approach, but there was no comparison with TPA.…”