Retrospective Comparison of Retroperitoneoscopic Versus Open Adrenalectomy for Pheochromocytoma

Liu, Bin; Fu, Bin; Ouyang, Jinzhi; Wang, Baojun; Zhang, Guoxi; Xu, Kai; Zhang, Jun; Wang, Chao; Shi, Taoping; Zhou, Hao-Miao; Ma, Xin; Zhang, Xu

doi:10.1016/j.juro.2007.08.147

Cited by 44 publications

(42 citation statements)

References 18 publications

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“…Guiding this practice is the fact that tumor manipulation has been shown to be the most significant intraoperative stimulus for catecholamine release during both open and laparoscopic resections. 27,30 Limiting tumor manipulation and applying pharmacological vasodilation when hypertension is persistent has resulted in no cardiovascular morbidity or mortality in our series. The sole exception was one patient who developed a severe pulmonary embolus and died after being hospitalized for a month.…”

Section: 21mentioning

confidence: 84%

Surgery for pheochromocytoma: A 20-year experience of a single institution

Aggeli

Nixon

Parianos

et al. 2018

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oBJECTIvE: Resection of pheochromocytomas is a challenging procedure due to hemodynamic lability. our aim was to evaluate surgical outcomes in 67 patients with pheochromocytoma and to validate the role of laparoscopic surgery in the treatment of these tumors. DEsIgn: This study is a retrospective review. A total of 68 procedures for pheochromocytoma were performed between June 1997 and february 2017. All patients were investigated and operated on using an established departmental protocol. Relevant data were retrieved from the hospital records of 533 patients who underwent 541 adrenalectomies for benign and malignant adrenal tumors in the same period. REsuLTs: sixty-nine tumors were removed from 67 patients. one patient with/mEn2A underwent bilateral resection of pheochromocytomas in two stages. Tumor size in laparoscopic procedures ranged from 1.2 cm to 11.0 cm (mean 5.87 cm). Thirty-seven patients had benign disease, 31 potentially malignant (based on PAss) and 1 malignant with metastasis. Eight were in the context of a familial syndrome. forty-nine patients underwent laparoscopic adrenalectomy, 8 patients had open approach from the start for recurrent pheochromocytoma or large benign tumor, 1 patient had open approach due to inoperable malignant pheochromocytoma and 10 patients had conversions from laparoscopic to open procedure. nine patients received sodium nitroprusside intraoperatively to treat hypertension. one patient developed pulmonary embolism and succumbed 1 month later. There were no recurrences of the benign or potentially malignant tumors during the follow-up period. ConCLusIons: Laparoscopic resection of pheochromocytomas, despite its increased level of difficulty compared to that of other adrenal tumors, is a safe and effective procedure.

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Section: 21mentioning

confidence: 84%

Surgery for pheochromocytoma: A 20-year experience of a single institution

Aggeli

Nixon

Parianos

et al. 2018

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“…Several authors have compared open or laparoscopic approaches retrospectively and concluded that laparoscopic adrenalectomy is superior in terms of intraoperative blood loss, transfusion rates, patient morbidity, start of oral intake, analgesia requirements as well as hospital stay [16,17] . Although long operative time was frequently reported in the early experience with laparoscopic adrenalectomy [18] , currently, it is obvious that the procedure provides a statistically significant shorter operative time [16] .…”

Section: Discussionmentioning

confidence: 99%

“…Although long operative time was frequently reported in the early experience with laparoscopic adrenalectomy [18] , currently, it is obvious that the procedure provides a statistically significant shorter operative time [16] . Moreover, laparoscopic adrenalectomy has been proved to be superior in both pediatric and morbidly obese patients [19,20] .…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Adrenal Tumors: A Single-Center Experience with 238 Cases

Gomha¹,

Osman²,

El-Mekresh³

et al. 2009

Urol Int

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Objective: It was the aim of this study to review and analyze clinical data on the diagnosis and management of patients with adrenal masses. Patients and Methods: Between 1976 and 2005, 238 patients admitted to our institute with adrenal masses were reviewed. Incidence, clinical features, imaging technique findings, surgical approaches, morbidity and mortality, as well as pathological diagnoses were reported. Results: The series comprised 134 males and 104 females (mean age 33.3 ± 20.3 years). Right-sided masses were more common (63.4%), with a mean size of 7.7 ± 4 cm. Pain was the most frequent presenting symptom (53.4%), while 62 (26%) had a functional tumor. Incidentaloma was diagnosed in 49 patients (20.6%). Both computed tomography and magnetic resonance imaging showed a high diagnostic yield (sensitivities of 98.9 and 100%, respectively). Open adrenalectomy was performed in 153 patients (64.3%), while a laparoscopic approach was employed in 53 patients (22.3%). The intraoperative complication rate was 14.7%, the postoperative complication rate 6.1% and perioperative mortality 1.7%. Most of the excised masses were pheochromocytomas (26.4%). Conclusions: Computed tomography is recommended as the first diagnostic modality to define and characterize adrenal masses. Laparoscopic adrenalectomy is currently replacing open surgery as the standard surgical management of adrenal masses.

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“…This initial experience has been followed by others using the same approach or, alternatively, the retroperitoneal approach with the patient in the prone or in the lateral decubitus position [6,7] and the transperitoneal approach with the patient supine [8]. Several reports have confirmed the safety and efficacy of these techniques, and minimally, invasive adrenalectomy is presently considered the treatment of choice for a variety of benign lesions, including lesions of the medulla [9,10].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Left Adrenalectomy with Submesocolic and Retropancreatic Approach

Balla¹,

Quaresima²,

Seitaj³

et al. 2017

Laparoscopic Surgery

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Introduction: The safety and efficacy of laparoscopic transperitoneal lateral adrenalectomy and retroperitoneoscopic adrenalectomy have been reported. The aim is to report the authors' experience in laparoscopic left adrenalectomy with an alternative transperitoneal submesocolic and retropancreatic approach with patient supine. Research methods:The authors have performed laparoscopic transperitoneal submesocolic, retropancreatic adrenalectomy for both benign and malignant, functioning lesions >4cm in diameter or with smaller lesions but having an imaging pattern suspicious of malignancy or of sub-clinically secreting tumors. After opening the posterior peritoneum at the root of the transverse mesocolon and Gerota's fascia, the junction of the inferior adrenal vein with the left renal vein is identified. The adrenal vein is then prepared and divided, followed by mobilization and removal of the left adrenal gland.Conclusion: Early ligation of the adrenal vein is the most relevant technical feature of this procedure to avoid the release of catecholamines, hormones or neoplastic cells which could occur during manipulation of the gland prior to ligation of the main adrenal vein. Moreover, this approach makes it possible to perform associated procedures, including a bilateral adrenalectomy, without the need to reposition the patient on the operative table, but simply by positioning additional trocars.

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Retrospective Comparison of Retroperitoneoscopic Versus Open Adrenalectomy for Pheochromocytoma

Abstract: Compared with open surgery retroperitoneoscopic lateral adrenalectomy for pheochromocytoma is a safe, minimally invasive and effective procedure.

Cited by 44 publications

References 18 publications

Surgery for pheochromocytoma: A 20-year experience of a single institution

Surgery for pheochromocytoma: A 20-year experience of a single institution

Diagnosis and Treatment of Adrenal Tumors: A Single-Center Experience with 238 Cases

Laparoscopic Left Adrenalectomy with Submesocolic and Retropancreatic Approach

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