Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?. (25th February 2018)

• Record Type: Journal Article
• Authors: Chung, Ho Seok; Kim, Myung Soo; Yu, Ho Song; Hwang, Eu Chang; Kim, Sun‐Ouck; Oh, Kyung Jin; Jung, Seung Il; Kang, Taek Won; Park, Kwangsung; Kwon, Dong Deuk
• Is Part Of: International journal of urology. Volume 25:Number 5(2018)
• Page Start: 414
• Page End: 419
• Publication Date: 2018-02-25
• Subjects: adrenalectomy -- hypertension -- laparoscopy -- pheochromocytoma; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.13524
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract : Objectives: To evaluate the surgical feasibility of laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of large pheochromocytomas, and to identify the preoperative risk factors for intraoperative hypertension. Methods: We retrospectively reviewed 51 patients who underwent laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of pheochromocytomas. Patient characteristics and perioperative outcomes were analyzed and compared between the two study groups based on tumor size: group A ( n = 27, ≤6 cm) and group B ( n = 24, ˃6 cm). Results: There was no significant difference in preoperative characteristics between the two groups except for tumor size ( P = 0.001) and urinary metanephrine ( P = 0.011). Group B patients required longer operating time ( P = 0.008), had a greater estimated blood loss ( P = 0.001) and hemoglobin change ( P = 0.002). However, no significant differences were observed in perioperative complications and mortality. Multivariate analysis showed that symptomatic pheochromocytomas ( P = 0.004) and tumor size ( P = 0.007) were significant risk factors for intraoperative hypertension. Conclusions: Laparoscopic adrenalectomy using the lateral retroperitoneal approach for pheochromocytomas can be regarded as a treatment option, even for tumors measuring >6 cm. Symptomatic pheochromocytomas and large tumor size seem to represent risk factors for intraoperative hypertension.