Surgical treatment of pheochromocytomas

Möbius, E.; Nies, C.; Rothmund, M.

doi:10.1007/s004649900893

Cited by 100 publications

(64 citation statements)

References 19 publications

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“…Some studies retrospectively compared groups of well-matched patients approached with these different modalities, concluding in favor of the laparoscopic approach [1,3,6,9,10,[13][14][15]19]. In fact, if Inabnet et al signaled the hypertensive crises to be more severe or to occur more frequently in the laparoscopic group, Fernandez Cruz and collaborators demonstrated a reduced increase of plasma catecholamine levels with significant benefit in terms of drug control of hypertensive peaks during laparoscopic surgery; this was ascribed to the less traumatic laparoscopic dissection, causing a reduced incretion of catecholamines, as measured by intraoperative multiple blood collections.…”

Section: Discussionmentioning

confidence: 99%

“…During laparoscopic surgery for pheochromocytoma, intraoperative haemodynamic instability remains a major concern and, even in experienced hands, the procedure may be associated with longer operative time, increased complication rates, and prolonged hospitalization, despite appropriate preoperative medical treatments, minimal invasiveness, and reduced manipulation of tumor. Since the first report by Gagner [4], some studies investigated the endocrine and cardiovascular effects of laparoscopic surgery for pheochromocytoma and demonstrated the safety and feasibility of laparoscopy [1,3,6,9,10,[13][14][15]19], belying the theoretical concerns about the effects of carbon dioxide pneumoperitoneum on the haemodynamics of patients with catecholaminesecreting tumors [7,17]. Considering that in these series the laparoscopic group of patients was compared to an historical one, we performed a prospective randomized comparison between laparoscopic and open surgery in patients affected by sporadic pheochromocytoma, in order to effectively compare the intraoperative haemodynamic consequences of the two surgical techniques, avoiding the bias linked to the evolution of medical and anaesthesiological protocols.…”

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confidence: 99%

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Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma

et al. 2008

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Background Laparoscopic adrenalectomy for pheochromocytoma remains subject of debate, owing to the systemic consequences of pneumoperitoneum in patients with catecholamine-secreting tumors. Methods A prospective randomized study was conducted (2000)(2001)(2002)(2003)(2004)(2005)(2006), evaluating cardiovascular instability during open (n = 9, group A) or laparoscopic (n = 13, group B) adrenalectomy for pheochromocytoma. Haemodynamic parameters were recorded by invasive monitoring. Results Haemodynamic instability was observed in 3/9 (group A) and 6/13 patients (group B), with a mean of 1.8 and 2.2 hypertensive peaks per patient (p = n.s.). Blood loss (164 ± 94 cc versus 48 ± 36 cc, p \ 0.05) and operative time (180 ± 40 versus 158 ± 45 min, p = n.s.) favored laparoscopic procedures. Postoperative morbidity and mortality were nil. Hospital stay was shorter in group B (p \ 0.05). Long-term follow-up was always normal.Conclusions Laparoscopic approach for pheochromocytoma can be as safe as open surgery; intraoperative haemodynamic instability, although usually controlled with success, remains a source of concern.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma

et al. 2008

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“…Interestingly, a creation of peritoneum has been shown to increase catecholamines release which may result in hemodynamic instability (35,48,49). Moreover, case control studies confirmed that in terms of hemodynamic instability laparoscopic approach is equal to open procedure (50,51). Moreover, a study by Kiernan et al demonstrated that after open surgery the risk of increased number of episodes of systolic blood pressure >200 mmHg was 27 times higher comparing to laparoscopy (52).…”

Section: Intraoperative Considerationsmentioning

confidence: 99%

Perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma

Pisarska¹,

Pędziwiatr²,

Budzyński³

2016

Gland Surg.

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“…La cirugía laparoscópica para feocromocitoma permite una manipulación más delicada, siendo no solamente viable desde el punto de vista técnico, sino que también es más segura en cuanto a los parámetros hemodinámicos. (7,(9)(10)(11)(12)16) En lo que se reiere a nuestro tiempo quirúrgico promedio (125 min) hemos empleado menos tiempo respecto a otras series publicadas (de 125-160min). Respecto a nuestro sangrado operatorio promedio de 90 cc, fue menor en comparación a otros estudios con mismo abordaje, así como también del estudio de Machado M et cols.…”

Section: Discussionunclassified

Transperitoneal Laparoscopic Suprarrenalectomy: Our Experience

et al. 2016

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Introducción: El abordaje laparoscópico representa el tratamiento quirúrgico ideal de las enfermedades de las glándulas suprarrenales, debido a las ventajas respecto a las técnicas abiertas en cuanto a seguridad, eficacia, menor morbilidad y pronta recuperación del paciente. Objetivo: Describir nuestros resultados en suprarrenalectomía videolaparoscópica transperitoneal. Pacientes y método: Observacional, descriptivo, retrospectivo, de corte transverso. Se presentan 14 casos de pacientes sometidos a suprarrenalectomía videolaparoscópica en un periodo de 2004 a 2016, con los diagnósticos de feocromocitomas en 8 casos, 2 adenomas con síndrome de Cushing, 1 adenoma no funcionante, 1 mielolipoma, 1 síndrome de Conn y 1 quiste epitelial benigno. Describimos la localización, el tamaño, el tiempo quirúrgico y de hospitalización, la pérdida sanguínea, complicaciones y evolución. Resultados: Fueron 13 mujeres y un varón, con edades comprendidas entre 18 a 55 años (promedio 31,1 años). Hubo equivalencia en cuanto a la localización izquierda y derecha. El tamaño varió de 5 a 10 cm (promedio de 8 cm). La media del tiempo quirúrgico fue de 125 min y de hospitalización de 3,5 días. El sangrado operatorio medio fue de 90 cc (de 30 a 260 cc). Como complicaciones tuvimos un caso de sangrado intraoperatorio a través de uno de los puertos, que se consigue cohibir mediante punto hemostático transparietal y otro caso de neumótorax derecho post punción de catéter de vía venosa central pre operatorio que requirió la colocación de un tubo de drenaje pleural. En ningún caso fue necesaria la conversión a cirugía abierta. No tuvimos óbitos. Conclusiones: En nuestra experiencia la suprarrenalectomía videolaparoscópica trasperitoneal es una técnica segura para el tratamiento de las enfermedades de las glándulas suprarrenales, con 14,3% de complicaciones y ningún óbito, así como estadía hospitalaria corta.Palabras clave: suprarrenalectomia, glandula adrenal, laparoscopia. ABSTRACT Introduction:The laparoscopic approach for adrenal tumors are the best option because of his safety to perform, poor or nothing morbidity and fast recovery. Objective: to describe the results of transperitoneal laparoscopic suprarrenalectomy (TLS). Patient and method: an observational, retrospective study of 14 patients who underwent TLS between 2004 to 2016. Results: 13 women and 1 man, with a range of age of 18 to 55 years, without difference of tumor localization side. The average size of the tumor was 8 cm and the OR time 125 min in most of the cases. The average of discharge from hospital was 3,5 days. The complications presented were a trocar hemorrhage resolved with a stich and a pneumothorax after yugular punction that required a pleural drainage. Conclusions: The TLS is a safety technique for adrenal tumors, with a complication rate of 14,3% and a short hospital admission.

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Surgical treatment of pheochromocytomas

Abstract: Laparoscopic adrenalectomy is a safe procedure for patients with pheochromocytoma.

Cited by 100 publications

References 19 publications

Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma

Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma

Perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma

Transperitoneal Laparoscopic Suprarrenalectomy: Our Experience

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