Safety of Laparoscopic Adrenalectomy in Patients with Large Pheochromocytomas: A Single Institution Review View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2008-05

AUTHORS

Giuseppe Ippolito, Fausto F. Palazzo, Frederic Sebag, Abhijit Thakur, Mariya Cherenko, Jean-François Henry

ABSTRACT

BACKGROUND: Laparoscopic adrenalectomy is the procedure of choice for small adrenal tumors, but some concerns have been voiced when this approach is adopted for larger tumors and pheochromocytomas. The aim of this study was to examine the results of the laparoscopic resection of large pheochromocytomas. METHODS: A retrospective review of adrenalectomies performed for adrenal pheochromocytomas>6 cm in diameter. We compiled and analyzed the early operative complications, histologic findings, and cure rates with a minimum of 1 year of follow-up after surgery. RESULTS: From 1996 to 2005, a total of 445 laparoscopic adrenalectomies were performed in our institution using the anterolateral transperitoneal approach. From this series we identified 18 procedures for pheochromocytomas with an average diameter on imaging of 78.2 mm (range 60-130 mm). All patients were rendered safe with a standard departmental protocol involving calcium-channel blockade initiated at least 2 weeks prior to surgery. The average peak intraoperative blood pressure was 187 mmHg. Capsular disruption occurred in two cases. One patient required an intraoperative blood transfusion due to intraoperative blood loss. No immediate conversions to an open procedure were required, but one patient underwent a delayed laparotomy for hematoma formation. Histologically, four of the adrenal tumors displayed evidence of vascular invasion. Biochemical cure was achieved in all patients after a median follow-up of 58 months (16-122 months). CONCLUSIONS: Laparoscopic adrenalectomy appears to be a safe and effective approach for large pheochromocytomas when no preoperative or intraoperative evidence of local invasion is present. More... »

PAGES

840-844

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-007-9327-5

DOI

http://dx.doi.org/10.1007/s00268-007-9327-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051122195

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/18064512


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47 schema:description BACKGROUND: Laparoscopic adrenalectomy is the procedure of choice for small adrenal tumors, but some concerns have been voiced when this approach is adopted for larger tumors and pheochromocytomas. The aim of this study was to examine the results of the laparoscopic resection of large pheochromocytomas. METHODS: A retrospective review of adrenalectomies performed for adrenal pheochromocytomas>6 cm in diameter. We compiled and analyzed the early operative complications, histologic findings, and cure rates with a minimum of 1 year of follow-up after surgery. RESULTS: From 1996 to 2005, a total of 445 laparoscopic adrenalectomies were performed in our institution using the anterolateral transperitoneal approach. From this series we identified 18 procedures for pheochromocytomas with an average diameter on imaging of 78.2 mm (range 60-130 mm). All patients were rendered safe with a standard departmental protocol involving calcium-channel blockade initiated at least 2 weeks prior to surgery. The average peak intraoperative blood pressure was 187 mmHg. Capsular disruption occurred in two cases. One patient required an intraoperative blood transfusion due to intraoperative blood loss. No immediate conversions to an open procedure were required, but one patient underwent a delayed laparotomy for hematoma formation. Histologically, four of the adrenal tumors displayed evidence of vascular invasion. Biochemical cure was achieved in all patients after a median follow-up of 58 months (16-122 months). CONCLUSIONS: Laparoscopic adrenalectomy appears to be a safe and effective approach for large pheochromocytomas when no preoperative or intraoperative evidence of local invasion is present.
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