Advertisement

Der Chirurg

, Volume 90, Issue 1, pp 23–28 | Cite as

Minimal-invasive Chirurgie retroperitonealer Paragangliome

Synopsis eigener Erfahrungen
  • M. K. WalzEmail author
Leitthema
  • 85 Downloads

Zusammenfassung

Retroperitoneale Paragangliome sind seltene Tumoren mit den Eigenschaften adrenaler Phäochromozytome. Sie kommen entweder sporadisch oder im Zusammenhang hereditärer Syndrome vor. Ihre Diagnostik umfasst endokrinologische Methoden und bildgebende Verfahren. Primäre Therapieoption ist die Operation, wobei aus unserer Sicht die minimal-invasiven Methoden als die Verfahren der ersten Wahl gelten. Dabei sollten infrarenale Paragangliome transperitoneal laparoskopisch entfernt werden und suprarenale Tumoren retroperitoneoskopisch angegangen werden.

Schlüsselwörter

Stresshormone Operative Therapie Nachbehandlung Laparoskopie Retroperitoneoskopie 

Minimally invasive surgery of retroperitoneal paragangliomas

Synopsis of personal experiences

Abstract

Retroperitoneal paragangliomas are rare tumors with the characteristics of adrenal pheochromocytomas. They may occur sporadically or in conjunction with hereditary syndromes. Diagnostic methods in paragangliomas include testing of catecholamine secretion and imaging procedures. The first choice treatment is surgical removal, which in the author’s opinion is preferably by minimally invasive approaches. Infrarenal paragangliomas should be excised using a laparoscopic transabdominal procedure. For suprarenal tumors the retroperitoneoscopic approach should be used.

Keywords

Stress hormones Surgical treatment Follow-up treatment Laparoscopy Retroperitonoscopy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M.K. Walz gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Supplementary material

Video: „Minimal-invasive Chirurgie retroperitonealer Paragangliome“ (© M.K. Walz, Essen)

Literatur

  1. 1.
    Babic B, Patel D, Aufforth R et al (2017) Pediatric patients with pheochromocytoma and paraganglioma should have routine preoperative genetic testing for common susceptibility genes in addition to imaging to detect extra-adrenal and metastatic tumors. Surgery 161:220–227CrossRefGoogle Scholar
  2. 2.
    Cochetti G, Barillaro F, Boni A et al (2014) Robot assisted laparoscopic excision of a paraganglioma: new therapeutic approach. Int Braz J Urol 40:279–280CrossRefGoogle Scholar
  3. 3.
    Di Daniele N, Canale MP, Tesauro M et al (2012) Preoperative embolization reduces the risk of cathecolamines release at the time of surgical excision of large pelvic extra-adrenal sympathetic paraganglioma. Case Rep Endocrinol 2012:481328PubMedPubMedCentralGoogle Scholar
  4. 4.
    Groeben H, Nottebaum BJ, Alesina PF et al (2017) Perioperative alpha-receptor blockade in phaeochromocytoma surgery: an observational case series. Br J Anaesth 118:182–189CrossRefGoogle Scholar
  5. 5.
    Houari N, Touzani S, Salhi H et al (2018) Retroperitoneal paraganglioma-induced cardiogenic shock rescued by preoperative arterial embolization. Case Rep Crit Care 2018:4058046PubMedPubMedCentralGoogle Scholar
  6. 6.
    Kumar S, Pragatheeswarane M, Sharma AP et al (2017) Expanding the horizon of robotic surgery to large pelvic paraganglioma. J Robot Surg 11:247–250CrossRefGoogle Scholar
  7. 7.
    Lenders JW, Duh QY, Eisenhofer G et al (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:1915–1942CrossRefGoogle Scholar
  8. 8.
    Mitchell J, Siperstein A, Milas M et al (2011) Laparoscopic resection of abdominal paragangliomas. Surg Laparosc Endosc Percutan Tech 21:e48–e53CrossRefGoogle Scholar
  9. 9.
    Noda E, Ishikawa T, Maeda K et al (2008) Laparoscopic resection of periadrenal paraganglioma: a report of 2 cases. Surg Laparosc Endosc Percutan Tech 18:310–314CrossRefGoogle Scholar
  10. 10.
    O’riordain DS, Young WF Jr., Grant CS et al (1996) Clinical spectrum and outcome of functional extraadrenal paraganglioma. World J Surg 20:916–921CrossRefGoogle Scholar
  11. 11.
    Petersenn S, Unger N, Walz MK et al (2006) Diagnostic value of biochemical parameters in the differential diagnosis of an adrenal mass. Ann N Y Acad Sci 1073:348–357CrossRefGoogle Scholar
  12. 12.
    Walz MK (1998) Minimal-invasive Nebennierenchirurgie. Chirurg 69:613–620CrossRefGoogle Scholar
  13. 13.
    Walz MK, Alesina PF, Wenger FA et al (2006) Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas: results of 161 tumors in 126 patients. World J Surg 30:899–908CrossRefGoogle Scholar
  14. 14.
    Walz MK, Iova LD, Deimel J et al (2018) Minimally invasive surgery (MIS) in children and adolescents with Pheochromocytomas and Retroperitoneal Paragangliomas: experiences in 42 patients. World J Surg 42:1024–1030CrossRefGoogle Scholar
  15. 15.
    Walz MK, Metz KA, Gorges R et al (2000) Endoscopic excision of extra-adrenal pheochromocytomas (paragangliomas). Chirurg 71:1504–1508CrossRefGoogle Scholar
  16. 16.
    Walz MK, Metz KA, Hellinger A et al (1997) Die Chirurgie primärer unilateraler Nebennierentumoren – Ergebnisse von 154 Patienten. Zentralbl Chir 122:481–486PubMedGoogle Scholar
  17. 17.
    Walz MK, Peitgen K, Hoermann R et al (1996) Posterior retroperitoneoscopy as a new minimally invasive approach for adrenalectomy: results of 30 adrenalectomies in 27 patients. World J Surg 20:769–774CrossRefGoogle Scholar
  18. 18.
    Walz MK, Peitgen K, Neumann HP et al (2002) Endoscopic treatment of solitary, bilateral, multiple, and recurrent pheochromocytomas and paragangliomas. World J Surg 26:1005–1012CrossRefGoogle Scholar
  19. 19.
    Walz MK, Peitgen K, Walz MV et al (2001) Posterior retroperitoneoscopic adrenalectomy: lessons learned within five years. World J Surg 25:728–734CrossRefGoogle Scholar
  20. 20.
    Wang J, Li Y, Xiao N et al (2014) Retroperitoneoscopic resection of primary paraganglioma: single-center clinical experience and literature review. J Endourol 28:1345–1351CrossRefGoogle Scholar
  21. 21.
    Xia L, Xu T, Wang X et al (2016) Robot-assisted laparoscopic resection of large retroperitoneal paraganglioma—initial experience from China. Int J Med Robot 12:686–693CrossRefGoogle Scholar
  22. 22.
    Xu W, Li H, Ji Z et al (2015) Comparison of retroperitoneoscopic versus transperitoneoscopic resection of retroperitoneal paraganglioma: a control study of 74 cases at a single institution. Medicine (Baltimore) 94:e538CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Chirurgie und Zentrum Minimal Invasive ChirurgieKliniken Essen-MitteEssenDeutschland

Personalised recommendations