Laparoscopic Resection of Adrenal and Extra-Adrenal Pheochromocytoma
Laparoscopic Resection of Adrenal and Extra-Adrenal Pheochromocytoma
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DOI：
10.1089/end.2012.0745
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发表时间：
2013-07-01
影响因子：
2.7
通讯作者：
Fuse, Hideki
中科院分区：
文献类型：
--
作者：
Nozaki, Tetsuo;Iida, Hiroaki;Fuse, Hideki
背景和目的：肾上腺外嗜铬细胞瘤（EAP）的腹腔镜切除术需要细致的外科手术，因为解剖处置和/或接近主要血管的变化。完全切除可能是创伤性的，并可能导致儿茶酚胺水平增加。我们介绍了我们的经验，腹腔镜下切除EAP（LEAP），并比较术中血流动力学与腹腔镜下切除肾上腺嗜铬细胞瘤（EEP）。（腔静脉后EAP，n = 2;腔静脉间EAP，n = 1;肾上腺周围EAP，n = 2）和5例在2001年10月至2011年10月期间接受了腹膜透析。我们还评估了波动的血压（BP）报告在这两个surgics.Results：在腹腔镜下的指导下，两组的肿瘤成功切除，并转换为开放手术或输血是不需要的。3名LEAP和4名LAP患者观察到术中高血压（BP > 200 mm Hg），而5名LEAP和3名LAP患者观察到术中低血压（BP <80 mm Hg）。两组之间没有显着差异，观察however.Conclusions：腹腔镜手术是有经验的外科医生在EAP切除术的选择方法，因为它是可行的和可重复的适当的术前规划，类似于腹腔镜手术。
Background and Purpose: Laparoscopic resection of extra-adrenal pheochromocytoma (EAPs) necessitates meticulous surgical procedures because of changes in anatomic disposition and/or proximity to major blood vessels. Complete resection can be traumatic and may cause an increase in catecholamine levels. We present our experiences with laparoscopic resection of EAP (LEAP) and compare the intraoperative hemodynamics with those during laparoscopic resection of adrenal pheochromocytoma (LAP).Patients and Methods: We retrospectively reviewed the medical records of five patients who underwent LEAP (retrocaval EAP, n = 2; interaortocaval EAP, n = 1; periadrenal EAP, n = 2) and five who underwent LAP between October 2001 and October 2011. We also evaluated fluctuations in blood pressure (BP) reported during both surgeries.Results: The tumors were successfully resected under laparoscopic guidance in both groups, and conversion to open surgery or blood transfusion was not needed. Intraoperative hypertension (BP > 200mm Hg) was observed in three LEAP and four LAP patients, whereas intraoperative hypotension (BP < 80mm Hg) was observed in five LEAP and three LAP patients. No significant differences were observed between groups, however.Conclusions: Laparoscopy is the method of choice for surgeons experienced in EAP resection because it is feasible and reproducible with appropriate preoperative planning, similar to LAP.