Suprarrenalectomía laparoscópica retroperitoneal como opción minimamente invasiva en el tratamiento de tumores adrenales

Tobias-Machado, Marcos; Ríos, Freddy Rincón; Lasmar, Marco Túlio Coelho; Tristão, Rodrigo Alves; Forseto, Pedro Jr Hermínio; Juliano, Roberto Vaz; Wroclawski, Eric Roger

doi:10.4321/s0004-06142006000100007

Cited by 8 publications

(2 citation statements)

References 20 publications

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“…Compared with the transperitoneal laparoscopic approach, which is commonly used to resect retroperitoneal tumors[ 13 – 15 ],the retroperitoneal laparoscopic approach has a few advantages, including shorter operative time, fewer disturbances to abdominal organs, and more rapid convalescence[ 8 , 16 – 18 ]. A few studies explored the feasibility of retroperitoneal laparoscopic resection of PG (RLPG)[ 11 , 12 , 19 ], and most of them reported successful outcomes.…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneal Laparoscopic Management of Paraganglioma: A Single Institute Experience

et al. 2016

PLoS ONE

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ObjectivesTo explore the feasibility and safety of retroperitoneal laparoscopic resection of paraganglioma (RLPG) in a large study population.MethodsIn a six-year period, 49 patients with primary retroperitoneal paragangliomas (PG) underwent retroperitoneal laparoscopic surgery in a single center. Medical records were reviewed, and collected the following data, which were clinical characteristics, perioperative data (operative time, estimated blood loss, intraoperative hemodynamic changes, intraoperative and postoperative complications, and open conversions), and follow-up data (recurrence or distant metastases).ResultsAll PGs were removed with negative tumor margin confirmed by postoperative histopathology. The operative time of RLPG was 101.59±31.12 minutes, and the estimated blood loss was 169.78±176.70ml. Intraoperative hypertensive and hypotensive episodes occurred in 25 cases and 27 cases, respectively. Two open conversions occurred. Two intraoperative complications occurred but were successfully managed endoscopically. Postoperative complications were minor and unremarkable. No local recurrence or distant metastasis were observed during the follow-up period.ConclusionsOur experience indicates the feasibility and safety of resection of PGs in a relatively large study population.

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Section: Introductionmentioning

confidence: 99%

Retroperitoneal Laparoscopic Management of Paraganglioma: A Single Institute Experience

et al. 2016

PLoS ONE

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“…However, it is known that the tumor diameter is an important factor in the surgical management of adrenal tumors using the retroperitoneal laparoscopic technique. Satisfactory clinical results of lateral retroperitoneal laparoscopic adrenalectomy (RLA) for small adrenal tumors have been reported [ 2 – 4 ]. Scholars have also reported that the largest adrenal benign tumor managed by the transperitoneal approach was 15 cm in diameter, and the largest adrenal benign tumor managed by the retroperitoneal method was 6 cm in diameter.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of large adrenal tumors: impact of different laparoscopic approaches and resection methods on perioperative and long-term outcomes

et al. 2018

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BackgroundThe indication of retroperitoneal laparoscopic adrenalectomy (RLA) was extended with the retroperitoneal approach and has been wildly accepted and technologically matured. However, the management of large adrenal tumors via this approach still remains controversial. The aim of this study was to perform a comprehensive analysis on the minimally invasive surgical management of larger adrenal tumors.MethodsA total of 78 patients with large adrenal tumors (> 5 cm) and 97 patients with smaller adrenal tumors (< 5 cm) were enrolled in this study. The patient characteristics were preferentially analyzed. The intra-operative and postoperative indicators were compared between those who underwent RLA and those who underwent transperitoneal laparoscopic adrenalectomy (TLA); the intra-operative and postoperative indicators were also compared between the large tumor group and smaller tumor group of those who underwent RLA. Furthermore, the analyses of partial RLA were focused on the perioperative indicators and follow-up results.ResultsRLA was superior to TLA in terms of operation time (98.71 ± 32.30 min vs. 124.36 ± 34.62 min, respectively, P = 0.001), hospitalization duration (7.43 ± 2.82 days vs. 8.91 ± 3.40 days, respectively, P = 0.04), duration of drain (4.83 ± 0.37 days vs. 3.94 ± 2.21 days, respectively, P = 0.02), first oral intake (2.82 ± 0.71 days vs. 1.90 ± 0.83 days, respectively, P < 0.001) and time to ambulation (3.89 ± 1.64 days vs. 2.61 ± 1.42 days, respectively, P < 0.001). Further analyses of the RLA patients demonstrated that the larger tumor (> 5 cm) group showed superior results for the intraoperative indicators than the smaller tumor (< 5 cm) group (P < 0.05), while the results for the postoperative indicators between the two tumor size groups were similar (P > 0.05). Data confirmed that the partial resection method was superior to the total resection method from the perspective of the hormone supplement (0% vs. 48.15%, P = 0.002). The 2-year recurrence-free rates were 92.60 and 92.86% for the total and partial RLA resection methods, respectively (P = 0.97). The partial RLA resection method had a similar complete remission rate as the total RLA resection method (96.30% vs. 100%, respectively, P = 0.47).ConclusionBoth RLA and TLA seem to provide similar effects for the surgical management of large adrenal tumors. However, partial RLA resection should be considered for the management of benign tumors to reduce the hormone supplement.Electronic supplementary materialThe online version of this article (10.1186/s12894-018-0349-0) contains supplementary material, which is available to authorized users.

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Abdominelle Voroperationen

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Meyer

Lammers

et al. 2007

Chirurg

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Benign adrenal gland tumors smaller than 6 cm are nowadays the indication for minimally invasive surgery. Until now there has been no significant difference between retroperitoneoscopic and transabdominal adrenalectomy. Intestinal adhesions could be a contraindication against transabdominal laparoscopic adrenalectomy, and therefore the retroperitoneoscopic approach could be an advantage in these cases. A prospective study concerning this question has not been published yet. Our clinical investigation here includes 114 adrenalectomies during the last 5 years. We show that in any case of abdominal preoperation, laparoscopic adrenalectomy can be performed by transabdominal approach and without conversion to open surgery. Discussed are the different indications for laparoscopic adrenalectomy, operating time, conversion rate to open surgery, and amount and type of abdominal preoperation. We compared patients with and without abdominal preoperations.

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Suprarrenalectomía laparoscópica retroperitoneal como opción minimamente invasiva en el tratamiento de tumores adrenales

Abstract: Retroperitoneoscopic adrenalectomy may be performed effectively and safely, with a low complication rate, independently of the etiology of the lesion. The lateral retroperitoneoscopic access is an excellent option for the minimally invasive treatment of the adrenal glands.

Cited by 8 publications

References 20 publications

Retroperitoneal Laparoscopic Management of Paraganglioma: A Single Institute Experience

Retroperitoneal Laparoscopic Management of Paraganglioma: A Single Institute Experience

Surgical management of large adrenal tumors: impact of different laparoscopic approaches and resection methods on perioperative and long-term outcomes

Abdominelle Voroperationen

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