Retroperitoneal laparoscopy rather than an open procedure for resection of pheochromocytomas could minimize intraoperative blood pressure fluctuations and transfusion events

Wang, Yanbo; Ding, Xiaobo; Hou, Yuchuan; Wang, Yan; Jiang, Fengjing; Zhang, Haifeng; Chun-xi, Wang

doi:10.1007/s11255-010-9839-z

Cited by 6 publications

(9 citation statements)

References 4 publications

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“…After removing duplicates, the remaining 469 relevant studies were further screened, and 253 were eliminated by scanning the titles and abstracts; full text review was performed on 32 articles. After reviewing the full text, 14 studies that met the criteria were included in the meta-analysis [ 6 – 8 , 13 , 18 – 27 ]. A flow chart of the literature retrieval summary is depicted in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…3 b). Three studies described the drainage tube indwelling time in 156 patients [ 8 , 26 , 27 ]; the drainage tube was removed earlier in the LS group than in the OS group after surgery (WMD = − 0.51 d, 95% CI: − 0.96 to − 0.07, P = 0.02, I 2 = 0% for heterogeneity, P = 0.41; Fig. 3 c).…”

Section: Resultsmentioning

confidence: 99%

“…The postoperative outcome indicators included in the present study were as follows: time to ambulation and oral intake, drainage tube indwelling time, postoperative length of stay, complications, and blood pressure control. Data regarding time to ambulation after surgery were available in three included studies involving 98 patients [8,25,26]. Time to ambulation was shorter in the LS group than that in the OS group (WMD = − 1.57 d, 95% CI: − 1.97 to − 1.16, P < 0.00001, I 2 = 17% for heterogeneity, P = 0.30; Fig.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…Conventional OS for PHEO has yielded great results in the past, but the procedure is traumatic and involves a large surgical incision. Recently, an increasing number of studies have suggested that LS is a safe and feasible procedure for PHEO and might become a more optimal approach than OS [ 6 – 8 ]. Indeed, LS was found in many studies to be superior to OS in terms of treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis

Wang

Chen

et al. 2020

BMC Surg

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Background: Surgical resection is the main treatment for pheochromocytoma (PHEO). Although open surgery (OS) has been shown to be safe and feasible, the safety and efficacy of laparoscopic surgery (LS) for PHEO remain controversial due to the uncertain effects of pneumoperitoneum on haemodynamics and the complexity of the tumour itself. This study was performed to compare the treatment outcomes of OS with those of LS for patients with PHEO. Methods: A systematic search through November 11, 2019, was conducted. All studies comparing outcomes of LS and OS for PHEO were included according to eligibility criteria. This meta-analysis was conducted using Review Manager Software, version 5.3, and STATA software, version 12.0. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Results: Fourteen studies involving 626 patients were included in this meta-analysis. LS was associated with lower rates of intraoperative haemodynamic instability (IHD) [odds ratio (OR) = 0.61, 95% CI: 0.37 to 1.00, P = 0.05], less intraoperative blood loss [weighted mean difference (WMD) = − 115.27 ml, 95% confidence interval (CI): − 128.54 to − 101.99, P < 0.00001], lower blood transfusion rates [OR = 0.33, 95% CI: 0.21 to 0.52, P < 0.00001], earlier ambulation (WMD = − 1.57 d, 95% CI: − 1.97 to − 1.16, P < 0.00001) and food intake (WMD = − 0.98 d, 95% CI: − 1.36 to − 0.59, P < 0.00001), shorter drainage tube indwelling time (WMD = − 0.51 d, 95% CI: − 0.96 to − 0.07, P = 0.02) and postoperative stay (WMD = − 3.17 d, 95% CI: − 4.76 to − 1.58, P < 0.0001), and lower overall complication rates (OR = 0.56, 95% CI: 0.35 to 0.88, P = 0.01). However, no significant differences in operative time, postoperative blood pressure control, rates of severe complications, postoperative hypotension or cardiovascular disease (CVD) were found between the two groups. Conclusions: LS is safe and effective for PHEO resection. Compared with OS, LS caused less IHD, providing an equal chance to cure hypertension while also yielding a faster and better postoperative recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis

Wang

Chen

et al. 2020

BMC Surg

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“…In addition, because it is possible to open up the operative field by changing the position of the patient, changes in blood pressure associated with catecholamine stimulation are minimized. Such blood pressure changes may develop upon manual compression of the tumor . Moreover, when a tumor in the retroperitoneum is removed via laparotomy, surgical manipulations are performed in the deepest location of the dorsal side, whereas a laparoscopic procedure allows such manipulations in a close and shallow position if a port is placed on the dorsal side.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic resection of a paraganglioma located on the border of the thoracic and abdominal cavities using a transabdominal‐transdiaphragmatic approach

Saito

Hirai

Nakazawa

et al. 2015

Asian J Endoscop Surgery

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We treated a 64-year-old woman with high blood pressure. Catecholamine metabolite levels were elevated in the blood and urine. CT revealed a densely stained tumor on the right side of the descending aorta dorsal to the inferior vena cava. PET-CT revealed abnormal accumulation of (18) F-fluorodeoxyglucose, and (123) I-meta-iodo-benzylguanidine uptake was apparent on scintigraphy. The tumor was determined to be a paraganglioma located on the border between the thoracic and abdominal cavities, and laparoscopic tumorectomy was performed. The patient was placed in the left lateral position. The right lobe of the liver was turned over, and we cut the diaphragm to expose the front of the tumor. We resected the straight artery flowing in from the aorta and removed the tumor safely. Herein, we describe the removal of a paravertebral paraganglioma located in the border of the thoracic and abdominal cavities with a laparoscopic transabdominal-transdiaphragmatic approach.

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6. Generation of Working Space: Extraperitoneal Approaches

Brams

2012

The SAGES Manual

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Retroperitoneal laparoscopy rather than an open procedure for resection of pheochromocytomas could minimize intraoperative blood pressure fluctuations and transfusion events

Cited by 6 publications

References 4 publications

Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis

Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis

Laparoscopic resection of a paraganglioma located on the border of the thoracic and abdominal cavities using a transabdominal‐transdiaphragmatic approach

6. Generation of Working Space: Extraperitoneal Approaches

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