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Laparoscopic adrenalectomy using the lateral retroperitoneal approach: Is it a safe and feasible treatment option for pheochromocytomas larger than 6 cm?
Author(s) -
Chung Ho Seok,
Kim Myung Soo,
Yu Ho Song,
Hwang Eu Chang,
Kim SunOuck,
Oh Kyung Jin,
Jung Seung Il,
Kang Taek Won,
Park Kwangsung,
Kwon Dong Deuk
Publication year - 2018
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13524
Subject(s) - medicine , adrenalectomy , perioperative , pheochromocytoma , urology , laparoscopy , surgery
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.