Laparoscopic adrenalectomy, a safe procedure for pheochromocytoma. A retrospective review of clinical series

Conzo, Giovanni; Musella, Mario; Corcione, Francesco; Palma, Maurizio De; Ferraro, Fausto; Palazzo, Antonietta; Napolitano, Salvatore; Milone, Marco; Pasquali, Daniela; Sinisi, Antonio Agostino; Colantuoni, Vittorio; Santini, Luigi

doi:10.1016/j.ijsu.2012.12.007

Cited by 82 publications

(92 citation statements)

References 28 publications

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“…This technique was described for the first time by Gagner in 1992 [1] and in the past years several studies have shown the advantages of laparoscopic approach [2] with decrease of the perioperative morbidity, lower complication rates, less operative blood loss, less postoperative pain and shorter hospital stay compared with open adrenalectomy [3]. On the contrary there are several doubts about laparoscopic approach in case of adrenocortical carcinoma [4,5].…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

Agrusa

Buono

Chianetta

et al. 2016

International Journal of Surgery

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a b s t r a c tIntroduction: Laparoscopic adrenalectomy is today considered the gold standard of treatment for adrenal tumors. The development of high definition cameras does not eliminate the major limitation of twodimensional (2D) laparoscopy: lack of depth perception and loss of spatial orientation. Treedimensional (3D) HD laparoscopy was developed as an alternative to conventional 2D laparoscopy. Methods: We report our experience with use of 3D vision system for laparoscopic adrenalectomy. Between January 2009 and March 2015 we performed a total of 52 laparoscopic adrenalectomies. In this case-control study we considered 13 laparoscopic adrenalectomies performed with three-dimensional (3D) vision system as case group. The last 26 procedures made with two-dimensional (2D) HD laparoscopic system represented the control group. We considered primary end-points: operative time, intraoperative complications and conversion rate. We evaluated also quality of depth perception and surgical strain. Results: Although the operative time for the entire surgical procedure was shorter in 3D group, there were no significant differences. The surgeon experienced better depth perception with 3D system and subjectively reported less strain using 3D vision system. Residents and medical students confirmed these data on surgical outcome. Conclusion: 3D system vision does not seem to influence the operative time of laparoscopic adrenalectomy performed by experienced surgeon because the surgical technique request simple tasks. We obtain the better visualization in depth perception with effect on surgical precision. Comparative studies are necessary to verify if 3D can reduce perioperative complication with similar operative time.

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Section: Introductionmentioning

confidence: 99%

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

Agrusa

Buono

Chianetta

et al. 2016

International Journal of Surgery

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“…haemodynamic disorders due to excessive manipulations [5]. Currently, the minimally invasive adrenalectomy is successfully used in more than 90% of phaeochromocytoma cases, preceded by preoperative pharmacotherapy to inhibit the hormonal activity of the tumor [6][7][8][9].…”

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confidence: 99%

A Comparison of Two Approaches to Laparoscopic Adrenalectomy: Lateral Transperitoneal Versus Posterior Retroperitoneal Approach

Marek-Safiejko¹,

Safiejko²,

Łukaszewicz³

et al. 2016

Adv Clin Exp Med

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diovascular and respiratory diseases, or those with obesity [1]. However, novel methods may prolong operative time when employed by trainee surgeons.During surgical procedures, the proper exposure of paired adrenal glands is challenging due to their small size, fragility and localization in the retroperitoneal area (deep inside the adipose tissue). Classical interventions require extensive incisions through integuments that are disproportionately large compared to the size of the glands [3].Surgery has recently made immense progress towards the minimization of invasiveness. Surgical trauma and the rate of complications have been limited significantly. As a result, decreased postoperative pain, shorter hospital stay, faster recovery, reduced mortality, improved cosmetic effect and decreased hospital costs have been observed [1,2]. Various studies conducted worldwide confirm the safety and efficacy of interventions that employ novel methods also in patients diagnosed with car- AbstractBackground. Laparoscopic adrenalectomy is the gold standard for the surgical treatment of benign adrenal masses. It is most commonly performed using the lateral transperitoneal approach (LTA) and the posterior retroperitoneal approach (PRA). The choice of the method depends on contraindications for a particular approach in an individual case and surgical experience. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature review. Objectives. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature. Material and Methods. The assessment involved morphological characteristics of tumors, indications for PRA and LTA, operative time, perioperative blood loss and postoperative complications. Results. Seventy-seven of the examined 104 laparoscopic adrenalectomies were performed retroperitoneally; 27 -transperitoneally. The mean size of tumors in PRA was 4.6 cm and in LTA 6.2 cm. The mean total operative time was 91.8 min in the case of PRA and 153.1 min in LTA. No differences in the amount of blood loss between the two approaches were recorded. The average hospitalization post PRA lasted 2.03 days and post LTA 2.67 days. Conclusions. Laparoscopic adrenalectomy proves to be an effective and safe surgical technique both in the case of LTA and PRA. The technique to be used should be suited to surgical team's experience, patient's general condition and tumor size and location. In our experience, the most advantageous approach in the case of tumors of less than 7 cm is PRA (Adv Clin Exp Med 2016, 25, 5, 829-835).

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“…Radical surgical resection is the treatment of choice for giant extra-adrenal pheochromocytomas [2]. Although preoperative selective angioembolization does not prevent intraoperative hypertensive crises, by facilitating the pharmacological management of the perioperative hemodynamic instability, we may avoid the onset of major adverse cardiovascular complications [7]; however, we have not found it to be necessary as adequate preoperative adrenergic blockade, careful intraoperative tumor handling, and early ligation of the feeding vessels as guided by the imaging prevented fluctuations of blood pressure in the intraoperative period. …”

Section: Discussionmentioning

confidence: 99%

Pelvic Pheochromocytoma: A Rare Lethal Tumor Initially Presenting as Tuboovarian Mass to Gynaecologist

Kumar

Pushkarna

Choudhary

et al. 2013

J Obstet Gynecol India

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Laparoscopic adrenalectomy, a safe procedure for pheochromocytoma. A retrospective review of clinical series

Cited by 82 publications

References 28 publications

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

A Comparison of Two Approaches to Laparoscopic Adrenalectomy: Lateral Transperitoneal Versus Posterior Retroperitoneal Approach

Pelvic Pheochromocytoma: A Rare Lethal Tumor Initially Presenting as Tuboovarian Mass to Gynaecologist

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