Perioperative, Functional, and Oncologic Outcomes of Partial Adrenalectomy for Multiple Ipsilateral Pheochromocytomas

Gupta, Gopal N.; Benson, Jonas S.; Ross, Michael J.; Sundaram, Vani; Lin, Kelly; Pinto, Peter A.; Linehan, W. Marston; Bratslavsky, Gennady

doi:10.1089/end.2013.0298

Cited by 17 publications

(18 citation statements)

References 14 publications

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“…In both of the groups no Addison crisis was observed and no steroid replacement was deemed to be necessary. Gupta et al (24) reported that out of 121 cases with PA applied on the pheochromocytoma patients (10 of such surgeries 8 patients with concurrent multiple pheochromocytoma on the similar location), there observed recoveries on the symptoms of all of the patients after 12 months while steroid replacement was a requisite for only one patient with solitary adrenal. In the contents of the study conducted by Chen et al (30) no hormone replacement was necessary as far as the PA was concerned, while out of 27 patients, replacement was a requisite for 13 patients who underwent TA r (0%/48.15%, p=0.002).…”

Section: Functional Resultsmentioning

confidence: 99%

“…Hemostatic agents may be used to minimize the potential postoperative hemorrhage There is no consensus concerning the quantity of the remaining adrenal tissue for the continuity of the physiological functions. There exist some studies suggesting the sparing of 1/3 of the remaining adrenal tissue while some other studies report that 20% of the well perfuzed adrenal is sufficient for preservation (19,(24)(25)(26).…”

Section: Techniquementioning

confidence: 99%

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Contemporary Trends in Adrenal Sparing Surgery

Gökalp¹,

Akdogan²,

Bayazit³

2020

uob

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Adrenal gland surgery has been practiced by the urologists ever increasingly in line with their interest in this particular field. Total adrenalectomy which is the classical approach for adrenal masses, is replaced by the organ-sparing surgery as soon as the significance of the organ sparing approach is understood as in the case of the renal masses. The partial adrenalectomy which has been in use through open surgery method since 1950's, was adapted to adrenal surgery by Gagner in 1991 and technical advancement was achieved since then with the introduction of the laparoscopic adrenalectomy by Janetschek six years later. Although it is increasingly being used, there still exist ambiguities concerning the technique and indications of the adrenal sparing surgery. In this review, the updated status of the adrenal sparing surgery is discussed with the current literature.

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Section: Functional Resultsmentioning

confidence: 99%

Section: Techniquementioning

confidence: 99%

Contemporary Trends in Adrenal Sparing Surgery

Gökalp¹,

Akdogan²,

Bayazit³

2020

uob

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“…For patients with bilateral adrenal pheochromocytomas, a staged approach is recommended; moreover, intervention should take place before the tumors reach 4cm to allow for the best functional outcomes [55]. Partial adrenalectomy can be performed using pure laparoscopy or with robotic assistance [53, 56], and results in reasonable outcomes even in those patients with a solitary adrenal gland [57]. …”

Section: Treatmentmentioning

confidence: 99%

“…Again, partial adrenalectomy should be considered in patients at risk for bilateral or multiple lesions [52, 57], and all patients should be counseled that steroid hormone replacement may ultimately be necessary [38]. …”

Section: Special Considerationsmentioning

confidence: 99%

Pheochromocytoma in Urologic Practice

Waingankar

Bratslavsky

Jiménez

et al. 2016

European Urology Focus

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Context Pheochromocytoma is regularly encountered in urological practice and requires a thoughtful and careful clinical approach. Objective To review clinical aspects of management of pheochromocytoma in urologic practice. Evidence Acquisition A systematic review of English-language literature was performed through year 2015 using the Medline database. Manuscripts were selected with consensus of the coauthors and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Evidence Synthesis Findings and recommendations of the evaluated manuscripts are discussed with an emphasis on the description of presentation, diagnosis, evaluation, and perioperative care. Conclusion In addition to surgical expertise, appropriate management of pheochromocytoma in urologic practice requires nuanced understanding of pathophysiology, genetics, and endocrinological principles. When skillfully managed, the vast majority of patients with pheochromocytoma should expect an excellent prognosis. Patient Summary In this article we review the clinical approach to patients with pheochromocytoma, a tumor that stems from the innermost part of the adrenal gland and that often secretes excessive amounts of powerful hormones such as noradrenaline and adrenaline. Significant expertise is required to appropriately manage patients with these tumors. Take Home Message In addition to surgical expertise, appropriate management of pheochromocytoma in urologic practice requires nuanced understanding of pathophysiology, genetics, and endocrinological principles. When skillfully managed, vast majority of patients with pheochromocytoma should expect an excellent prognosis.

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“…Таким образом, в условиях большого количества так называемых диагностических операций актуальным стал вопрос о возможностях выполнения органосохраняющих вмешательств. Особенно значимо сохранение части гормонопродуцирующей ткани у пациентов с билатеральными образованиями или высоким риском возникновения в последующем опухоли в контралатеральном надпочечнике, что возможно как спорадически, так и при некоторых наследственных патологиях [7,8].…”

Section: Introductionunclassified

Comparison of adrenal tumor treatment results by different volume of surgical interventions.

Semenov

Юрьевич²,

Панкова

et al. 2016

Endo Serg

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Results. Performing the organ-sparing operations doesn't increase the risk of intraoperative complications. In all patients with hormone-active tumors we found decline of pathologically increased hormone levels and trend to regress of clinical manifestations of the disease in early postoperative period. We found no difference in local recurrences in both groups, and its occurrence did not exceed 3.33%. Refractory postoperative adrenal insufficiency was observed only in corticosteroma patients in spite of surgery volume. In case of both side adrenal tumors there was no need in replacement therapy after total adrenalectomy from there one side and resection from the other. Conclusions. In cases of adrenal tumor performing organ-sparing operations is advisable, if there are no preoperative sings of malignancy.

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Perioperative, Functional, and Oncologic Outcomes of Partial Adrenalectomy for Multiple Ipsilateral Pheochromocytomas

Abstract: Minimally invasive surgical resection of synchronous multiple pheochromocytomas is feasible with acceptable perioperative, functional, and short-term oncologic outcomes.

Cited by 17 publications

References 14 publications

Contemporary Trends in Adrenal Sparing Surgery

Contemporary Trends in Adrenal Sparing Surgery

Pheochromocytoma in Urologic Practice

Comparison of adrenal tumor treatment results by different volume of surgical interventions.

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