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Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery 2011 Sep;150(3):452-8

Date

09/01/2011

Pubmed ID

21878230

DOI

10.1016/j.surg.2011.07.004

Scopus ID

2-s2.0-80052286967 (requires institutional sign-in at Scopus site)   86 Citations

Abstract

INTRODUCTION: Laparoscopic adrenalectomy (LA) is a safe minimally invasive approach for treatment of pheochromocytoma (PHEO). Posterior retroperitoneoscopic adrenalectomy (PRA) is an alternative minimally invasive technique; however, there is a lack of data regarding the appropriateness of this approach in patients with PHEO.

METHODS: Our endocrine surgery database was queried to identify patients who underwent LA or PRA for PHEO. Patient and tumor characteristics, as well as operative details and postoperative course were compared between the 2 groups.

RESULTS: LA or PRA was attempted in 46 patients with PHEO (23 LA, 23 PRA). There were no differences in age, BMI, or tumor size between these groups. PRA was associated with significantly reduced operative times (99 min vs 145 min, P < .001), estimated blood loss (8.4 cc vs 123.8 cc, P = .02), and postoperative length of stay (1.9 nights vs 3.1 nights, P < .01). There was no significant difference in rates of conversion to an open procedure or perioperative complications between these groups.

CONCLUSION: LA and PRA are both safe and effective approaches in patients with PHEO. In our experience, PRA results in decreased operative times, blood loss, and postoperative length of stay compared with LA. PRA has become our preferred approach for patients with PHEO.

Author List

Dickson PV, Alex GC, Grubbs EG, Ayala-Ramirez M, Jimenez C, Evans DB, Lee JE, Perrier ND

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Abdominal Wall
Adrenal Gland Neoplasms
Adrenalectomy
Adult
Cohort Studies
Databases, Factual
Female
Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Male
Middle Aged
Minimally Invasive Surgical Procedures
Pain, Postoperative
Pheochromocytoma
Postoperative Complications
Retroperitoneal Space
Retrospective Studies
Safety Management
Treatment Outcome
Young Adult