Document Detail


Retroperitoneoscopic adrenalectomy: comparison of retrograde and antegrade approach among a series of 279 cases.
MedLine Citation:
PMID:  23273074     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To compare the results of retroperitoneal laparoscopic adrenalectomy using the antegrade and retrograde approach.
MATERIALS AND METHODS: We performed an analysis of a single-center series of 279 retroperitoneal laparoscopic adrenalectomies from 1996 to 2010. We compared 172 cases performed with an antegrade approach and 107 with a retrograde approach without dissection of the renal hilum and initial control of the adrenal vein in comparable populations.
RESULTS: The operative time was shorter in the group treated with the retrograde technique, 101 ± 51 vs 140 ± 40 minutes, respectively (Student's t test, P <.001). Blood loss was similar in both groups, 85 ± 224 vs 80 ± 126 mL, respectively (P = NS). Hemodynamic instability was defined as the maximal systolic blood pressure minus the minimal systolic blood pressure divided the maximal systolic blood pressure. It was lower in the group who underwent the retrograde technique (32.7 vs 37.6 mL; Student's t test, P = .005) with a lower perioperative consumption of ephedrine (2.2 vs 5.1 mg, P = .004) and atropine (0.09 vs 0.22 mg, P = .026). No difference was found between the 2 groups in the frequency of perioperative complications or postoperative mortality (1 death in each group of causes unrelated to the surgery).
CONCLUSION: Retroperitoneal laparoscopic adrenalectomy using a retrograde approach is a safe and reproducible technique. It makes it possible to perform adrenalectomy without dissection of the renal hilum, with a reduction in the operative time. The good hemodynamic stability observed with this technique makes it very attractive for the treatment of pheochromocytoma.
Authors:
Eric Huyghe; Guillaume Crenn; Béatrice Duly-Bouhanick; Delphine Vezzosi; Antoine Bennet; Fouad Atallah; Michel Mazerolles; Ali Salloum; Matthieu Thoulouzan; Boris Delaunay; Solange Grunenwald; Jacques Amar; Pierre Plante; Bernard Chamontin; Philippe Caron; Michel Soulié
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  81     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  85-92     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Toulouse Rangueil University Hospital, Toulouse, France. Electronic address: huyghe.e@chu-toulouse.fr.
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