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Laparoscopic adrenalectomy for pheochromocytoma

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Abstract

Laparoscopic adrenalectomy has become the standard technique for the surgical removal of the adrenal gland for functional adrenal tumors including aldosteronoma, glucocorticoid, and androgen/estrogen-producing adenomas. Many laparoscopic surgeons also think that for small to moderately sized pheochromocytomas, the laparoscopic approach is as safe and effective as the open technique. Several physiologic considerations specific to pheochromocytoma must be addressed before and during surgery regardless of the operative approach. The advantages of laparoscopic adrenalectomy over open adrenalectomy remain the same for pheochromocytomas as for other pathologic conditions of the adrenal gland. These include a shorter length of stay, a decrease in postoperative pain, a shorter time to return to preoperative activity level, and improved cosmesis.

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References and Recommended Reading

  1. Gagner M, Lacroix A, Bolte E: Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med 1992, 327:1033.

    Article  PubMed  CAS  Google Scholar 

  2. MacGillivary DC, Shicman SJ, Ferrer FA: A comparison of open vs. laparoscopic adrenalectomy. Surg Endosc 1996, 10:987–990.

    Article  Google Scholar 

  3. Gagner M, Breton G, Pharand D, Pomp A: Is laparoscopic adrenalectomy indicated for pheochromocytomas? Surgery 1996, 120:1076–1080.

    Article  PubMed  CAS  Google Scholar 

  4. Gagner M, Pomp A, Heniford BT, et al.: Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg 1997, 226:238–247.

    Article  PubMed  CAS  Google Scholar 

  5. Gagner M: Laparoscopic adrenalectomy. Surg Clin North Am 1996, 76:523–537.

    Article  PubMed  CAS  Google Scholar 

  6. Vaughan ED, Blumenfeld J, Del Pizzo JJ, et al.: Adrenal glands. In Campbell’s Urology, edn 8. Edited by Walsh PC, Retik AB, Vaughan ED, Wein AP. Philadelphia: WB Saunders; 2002:2915–2972.

    Google Scholar 

  7. Joris JL, Hamoir EE, Hartstein GM, et al.: Hemodynamic changes and catecholamine release during laparoscopic adrenalectomy for pheochromocytoma. Anesth Analg 1999, 88:16–21.

    Article  PubMed  CAS  Google Scholar 

  8. Van Heerden JA, Sheps SG, Hamberger B, et al.: Pheochromocytoma: current status and changing trends. Surgery 1982, 91:367–373.

    PubMed  Google Scholar 

  9. Scott HW Jr, Oates JA, Nies AS, et al.: Pheochromocytoma: present diagnosis and management. Ann Surg 1976, 183:587–593.

    Article  PubMed  Google Scholar 

  10. Scott HW Jr, Van Way CW 3rd, Gray GF, Sussman CR: Pheochromocytoma. In Surgery of the Adrenal Glands. Edited by Scott HW. Philadelphia: JB Lippincott; 1990.

    Google Scholar 

  11. Williams DT, Dann S, Wheeler MH: Pheochromocytoma: views on current management. Eur J Surg Oncol 2003, 29:483–490.

    Article  PubMed  CAS  Google Scholar 

  12. Manger WM, Gifford RW Jr: Pheochromocytoma. In Hypertension: Pathophysiology, Diagnosis and Management. Edited by Laragh JH, Brenner BM. New York: Raven Press; 1990.

    Google Scholar 

  13. Thomas JL, Bernardino ME, Samaan NA, Hickey RC: CT of pheochromocytoma. AJR Am J Roentgenol 1980, 135:477–482.

    PubMed  CAS  Google Scholar 

  14. Abrams HL, Siegelman S, Adams DF, et al.: Computed tomography versus ultrasound of the adrenal gland: a prospective study. Radiology 1982, 143:121–128.

    PubMed  CAS  Google Scholar 

  15. Reinig JW, Doppman JL, Dwyer AJ, et al.: Adrenal masses differentiated by MR. Radiology 1986, 158:81–84.

    PubMed  CAS  Google Scholar 

  16. Shapiro B, Copp JE, Sisson JC, et al.: Iodine-131 metaiodobenzylguanidine for the locating of suspected pheochromocytoma: experience in 400 cases. J Nucl Med 1985, 26:576–785.

    PubMed  CAS  Google Scholar 

  17. Campeau RJ, Garcia OM, Correa OA, Rege AB: Pheochromocytoma: diagnosis by scintigraphy using Iodine I131 metaiodobenzyl-guanidine. Southern Med J 1991, 84:1221–1230.

    Article  CAS  PubMed  Google Scholar 

  18. Ulchaker JC, Goldfarb DA, Bravo EL, Novick AC: Successful outcomes in pheochromocytoma surgery in the modern era. J Urol 1999, 161:764–767.

    Article  PubMed  CAS  Google Scholar 

  19. Del Pizzo JJ, Shichman SJ, Sosa RE: Laparoscopic adrenalectomy: the New York-Presbyterian Hospital experience. J Endourol 2002, 16:591–597.

    Article  Google Scholar 

  20. Fernandez-Cruz L, Taura P, Saenz A, et al.: Laparoscopic approach to pheochromocytoma: hemodynamic changes and catecholamine secretion. World J Surg 1996, 20:762–768.

    Article  PubMed  CAS  Google Scholar 

  21. Sprung J, O’Hara JF Jr, Gill IS, et al.: Anesthetic aspects of laparoscopic and open adrenalectomy for pheochromocytoma. Urology 2000, 55:339–343. The experience at the Cleveland Clinic Foundation is the largest series of minimally invasive extirpative adrenal surgery and this study highlights important points regarding the intraoperative anesthetic management of patients undergoing this procedure.

    Article  PubMed  CAS  Google Scholar 

  22. Zeh HJ 3rd, Udelsman R: One hundred laparoscopic adrenalectomies: a single surgeon’s experience. Ann Surg Oncol 2003, 10:1012–1017.

    Article  PubMed  Google Scholar 

  23. Bolli M, Oertli D, Staub JJ, Harder F: Laparoscopic adrenalectomy: the new standard? Swiss Med Wkly 2002, 132:12–16.

    PubMed  Google Scholar 

  24. Miccoli P, Bendinelli C, Materazzi G, et al.: Traditional versus laparoscopic surgery in the treatment of pheochromocytoma: a preliminary study. J Laparoendosc Adv Surg Tech A 1997, 7:167–171.

    Article  PubMed  CAS  Google Scholar 

  25. Chigot JP, Menegaux F, Movschin M, et al.: La surrenalectomie laparoscopique dans les pehochromocytomes. Presse Med 1998, 27:359–360.

    PubMed  CAS  Google Scholar 

  26. Janetschek G, Altarac S, Finkenstedt G, et al.: Technique and results of laparoscopic adrenalectomy. Eur Urol 1996, 30:475–479.

    PubMed  CAS  Google Scholar 

  27. Mobius E, Nies C, Rothmund M: Surgical treatment of pheochromocytomas: laparoscopic or conventional? Surg Endosc 1999, 13:35–39.

    Article  PubMed  CAS  Google Scholar 

  28. Cheah WK, Clark OH, Horn JK, et al.: Laparoscopic adrenalecotmy for pheochromocytomas. World J Surg 2002, 26:1048–1051.

    Article  PubMed  Google Scholar 

  29. Gotoh M, Ono Y, Hattori R, et al.: Laparoscopic adrenalectomy for pheochromocytoma: morbidity compared with adrenalectomy for tumors of other pathology. J Endourol 2002, 16:245–249. This study highlights the morbidity specific to laparoscopic adrenalectomy for pheochromocytoma compared with other forms of adrenal disease, taking into account complications related to the biochemistry of the tumor.

    Article  PubMed  Google Scholar 

  30. Radmayr C, Neumann H, Bartsch G, et al.: Laparoscopic partial adrenalectomy for bilateral pheochromocytoma in a boy with von Hipple-Lindau disease. Eur Urol 2000, 38:344–348.

    Article  PubMed  CAS  Google Scholar 

  31. Walther MM, Herring J, Choyke PL, et al.: Laparoscopic partial adrenalectomy in patients with hereditary forms of pheochromocytoma. J Urol 2000, 164:14–17.

    Article  PubMed  CAS  Google Scholar 

  32. Kaouk JH, Matin S, Bravo EL, Gill IS: Laparoscopic bilateral partial adrenalectomy for pheochromocytoma. Urology 2002, 60:1100–1103. This is an important study discussing the role of minimally invasive adrenal-sparing surgery, a technically challenging laparoscopic procedure.

    Article  PubMed  Google Scholar 

  33. Salomon L, Rabii R, Soulie M, et al.: Experience with retroperitoneal laparoscopic adrenalectomy for pheochromocytoma. J Urol 2001, 165:1871–1874.

    Article  PubMed  CAS  Google Scholar 

  34. Chiu AW, Chang LS, Birkett DH, et al.: The impact of pneumoperitoneum, pneumoretroperitoneum and gasless laparoscopy on the systemic and renal hemodynamics. J Am Coll Surg 1995, 181:397–406.

    PubMed  CAS  Google Scholar 

  35. Heniford BT, Arca MJ, Walsh RM, Gill IS: Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 1999, 16:293–306.

    Article  PubMed  CAS  Google Scholar 

  36. Gill IS, Schweizer D, Nelson D: Laparoscopic versus open adrenalectomy in 210 patients: Cleveland Clinic experience with 210 cases [Abstract 70]. J Urol 1999, 161(suppl):21.

    Article  Google Scholar 

  37. Basso N, De Leo A, Fantini A, et al.: Laparoscopic direct supragastric left adrenalectomy. Am J Surg 1999, 178:308–310.

    Article  PubMed  CAS  Google Scholar 

  38. Gasman D, Droupy S, Koutani A, et al.: Laparoscopic adrenalectomy: the retroperitoneal approach. J Urol 1998, 159:1816–1820.

    Article  PubMed  CAS  Google Scholar 

  39. Fazeli-Martin S, Gill IS, Hsu TH, et al.: Laparoscopic renal and adrenal surgery in obese patients: comparison to open surgery. J Urol 1999, 162:665–669.

    Article  Google Scholar 

  40. Shen WT, Lim RC, Siperstein AE, et al.: Laparoscopic versus open adrenalectomy for the treatment of primary hyperaldosteronism. Arch Surg 1999, 134:628–632.

    Article  PubMed  CAS  Google Scholar 

  41. Yoshida O, Terachi T, Matsuda T, et al.: Complications in 369 laparoscopic adrenalectomies: a multi-institutional study in Japan [Abstract 1098]. J Urol 1997, 157(suppl):282.

    Article  Google Scholar 

  42. Korman JE, Ho T, Hiatt JR, et al.: Comparison of laparoscopic and open adrenalectomy. J Urol 1999, 162:1264.

    Article  Google Scholar 

  43. Bonjer HJ, Lange JF, Kazemier G, et al.: Comparison of three techniques for adrenalectomy. Br J Surg 1997, 84:679–682.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, The New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, 10021, New York, NY, USA

    Joseph J. Del Pizzo MD

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  1. Joseph J. Del Pizzo MD
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  2. Jonathan D. Schiff MD
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  3. E. Darracott Vaughan MD
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Del Pizzo, J.J., Schiff, J.D. & Vaughan, E.D. Laparoscopic adrenalectomy for pheochromocytoma. Curr Urol Rep 6, 78–85 (2005). https://doi.org/10.1007/s11934-005-0071-9

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