Document Detail


Is laparoscopic adrenalectomy indicated for pheochromocytomas?
MedLine Citation:
PMID:  8957498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since the introduction of laparoscopic adrenalectomy there has been major concern about proper indications for its use, including in pheochromocytoma. In this study we reviewed pheochromocytomas resected by means of laparoscopy to establish that procedure's usefulness. METHODS: Between January 1992 and June 1995, 90 laparoscopic adrenalectomies were performed in 82 patients. Three to five trocars were used intraperitoneally in each patient to remove the gland, and extraction was performed with a sterile plastic bag. RESULTS: Twenty-three pheochromocytomas were operated on. Six patients had a bilateral adrenalectomy. Pheochromocytomas were significantly larger than other tumors, required more operating time, and necessitated longer hospital stays in patients. Of all the intraoperative complications 87% occurred in the pheochromocytoma group; 67% of all postoperative complications occurred in this group. In four patients metastasis from pheochromocytoma to the liver was unexpectedly found, and in one case metastasis from a medullary thyroid carcinoma was found. There has been no local recurrence after laparoscopic adrenalectomy. CONCLUSIONS: Laparoscopic adrenalectomy for pheochromocytomas is difficult because tumors are larger and more complications are seen related to their hormonal secretions, in spite of adequate pharmacologic blockade. However, metastatic extensions can be diagnosed and laparoscopic ablation can be performed in most instances without recurrence. It is not, therefore, a contraindication for this approach.
Authors:
M Gagner; G Breton; D Pharand; A Pomp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  120     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-10     Completed Date:  1997-01-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1076-9; discussion 1079-80     Citation Subset:  AIM; IM    
Affiliation:
Department of General Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / surgery*
Adrenalectomy*
Female
Humans
Intraoperative Complications
Laparoscopy*
Male
Multiple Endocrine Neoplasia Type 2a / surgery
Multiple Endocrine Neoplasia Type 2b / surgery
Pheochromocytoma / surgery*
Postoperative Complications
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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