Does laparoendoscopic single-site adrenalectomy increase surgical risk in patients with pheochromocytoma?

Seiya Hattori, Akira Miyajima, Takahiro Maeda, Masanori Hasegawa, Toshikazu Takeda, Takeo Kosaka, Eiji Kikuchi, Ken Nakagawa, Mototsugu Oya

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: LESS (laparoendoscopic single-site) surgery has been developed as a treatment option for adrenal tumors that has less postoperative pain and greater cosmetic benefits. Some reports proposed that patient selection criteria should be stringent, and pheochromocytoma (PHE) should be taken as an advanced indication. The aim of this study is to compare LESS adrenalectomy (ADX) with conventional adrenalectomy (CL-ADX) in patients with PHE, with attention paid not only to immediate postoperative outcomes but also to the intraoperative hemodynamic changes that occur with each technique. Methods: The records of 265 consecutive patients who underwent laparoscopic ADX at Keio University Hospital in Tokyo from January 2001 to June 2011 were entered into a database. Surgical procedures were performed or supervised by two experienced laparoscopic surgeons, who performed more than 100 cases of urologic laparoscopic surgery in 2011. Twenty consecutive patients who underwent LESS-ADX from December 2009 to October 2011 were compared with patients who underwent CL-ADX (controls, n = 30) to look at differences in hemodynamic parameters and surgical outcomes in a case-control analysis. Results: Each group was equivalent with respect to age, sex, and BMI. The mean size of 50 PHE was 45.1 ± 4.0 mm, the mean operative time was 151.8 ± 10.6 min, and there was no significant difference between the two groups. In one case of LESS-ADX, two additional ports were added. There was no significant difference between the CL-ADX and LESS-ADX groups in terms of operation time, total fluid during the operation, estimated blood loss, first oral feeding, postoperative stay in the intensive care unit, or postoperative hospital stay. Conclusions: We consider the safety of LESS-ADX of PHE as similar to that of CL-ADX. With appropriate pre- and intraoperative hemodynamic control and experienced hands, LESS-ADX could become one of the treatments of choice for resection of PHE.

Original languageEnglish
Pages (from-to)593-598
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume27
Issue number2
DOIs
Publication statusPublished - 2013 Feb

Fingerprint

Adrenalectomy
Pheochromocytoma
Hemodynamics
Patient Selection
Glandular and Epithelial Neoplasms
Tokyo
Operative Time
Postoperative Pain
Cosmetics
Laparoscopy
Intensive Care Units
Length of Stay
Hand
Databases
Safety
Therapeutics

Keywords

  • Adrenal
  • Laparoendoscopic single-site surgery
  • Urology

ASJC Scopus subject areas

  • Surgery

Cite this

Does laparoendoscopic single-site adrenalectomy increase surgical risk in patients with pheochromocytoma? / Hattori, Seiya; Miyajima, Akira; Maeda, Takahiro; Hasegawa, Masanori; Takeda, Toshikazu; Kosaka, Takeo; Kikuchi, Eiji; Nakagawa, Ken; Oya, Mototsugu.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 27, No. 2, 02.2013, p. 593-598.

Research output: Contribution to journalArticle

Hattori, Seiya ; Miyajima, Akira ; Maeda, Takahiro ; Hasegawa, Masanori ; Takeda, Toshikazu ; Kosaka, Takeo ; Kikuchi, Eiji ; Nakagawa, Ken ; Oya, Mototsugu. / Does laparoendoscopic single-site adrenalectomy increase surgical risk in patients with pheochromocytoma?. In: Surgical Endoscopy and Other Interventional Techniques. 2013 ; Vol. 27, No. 2. pp. 593-598.
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abstract = "Background: LESS (laparoendoscopic single-site) surgery has been developed as a treatment option for adrenal tumors that has less postoperative pain and greater cosmetic benefits. Some reports proposed that patient selection criteria should be stringent, and pheochromocytoma (PHE) should be taken as an advanced indication. The aim of this study is to compare LESS adrenalectomy (ADX) with conventional adrenalectomy (CL-ADX) in patients with PHE, with attention paid not only to immediate postoperative outcomes but also to the intraoperative hemodynamic changes that occur with each technique. Methods: The records of 265 consecutive patients who underwent laparoscopic ADX at Keio University Hospital in Tokyo from January 2001 to June 2011 were entered into a database. Surgical procedures were performed or supervised by two experienced laparoscopic surgeons, who performed more than 100 cases of urologic laparoscopic surgery in 2011. Twenty consecutive patients who underwent LESS-ADX from December 2009 to October 2011 were compared with patients who underwent CL-ADX (controls, n = 30) to look at differences in hemodynamic parameters and surgical outcomes in a case-control analysis. Results: Each group was equivalent with respect to age, sex, and BMI. The mean size of 50 PHE was 45.1 ± 4.0 mm, the mean operative time was 151.8 ± 10.6 min, and there was no significant difference between the two groups. In one case of LESS-ADX, two additional ports were added. There was no significant difference between the CL-ADX and LESS-ADX groups in terms of operation time, total fluid during the operation, estimated blood loss, first oral feeding, postoperative stay in the intensive care unit, or postoperative hospital stay. Conclusions: We consider the safety of LESS-ADX of PHE as similar to that of CL-ADX. With appropriate pre- and intraoperative hemodynamic control and experienced hands, LESS-ADX could become one of the treatments of choice for resection of PHE.",
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AU - Miyajima, Akira

AU - Maeda, Takahiro

AU - Hasegawa, Masanori

AU - Takeda, Toshikazu

AU - Kosaka, Takeo

AU - Kikuchi, Eiji

AU - Nakagawa, Ken

AU - Oya, Mototsugu

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