Page 23 - World Journal of Laparoscopic Surgery

Malikendra Patel

equal to 6 cm is highly suggestive of malignancy 20,21 9. Fernandez-Cruz L, Taura P, Saenz A, et al. Laparoscopic
Laparoscopy is a limited approach to the adrenal, requiring approach to pheochromocytoma: Hemodynamic changes and
manipulation of the gland to remove it. In patients with catecholamine secretion. World J Surg 1996;20:762-68; discussion
cancer,wide resection of the gland with contiguous structures 768.
provides the best chance for cure. 22 10. de La Chapelle A, Deghmani M, Dureuil B. Peritoneal insufflation
can be a critical moment in the laparoscopic surgery of
The lateral transperitoneal approach is preferred over the pheochromocytoma. Ann Fr Anesth Reanim. 1998;17:1184-85.
retroperitoneal approach because of improved working space 11. Rose CE Jr, Althaus JA, Kaiser DL, et al. Acute hypoxemia and
23
and gland visualization. The resected gland is removed from hypercapnia: Increase in plasma catecholamines in conscious
the port site in an occlusive bag to decrease peritoneal dogs. Am J Physiol 1983;245:H924-29.
implantation and port site recurrence. 12. Cheah WK, Clark OH, Horn JK, et al. Laparoscopic
The question is not weather laparoscopic adrenalectomy adrenalectomy for pheochromocytoma. World J Surg
2002;26:1048-51.
foradrenal tumors should be done or not, but by whom should 13. Kercher KW, Park A, Matthews BD, et al. Laparoscopic
it be performed. A surgeon who is very proficient adrenalectomy for pheochromocytoma. Surg Endosc.
laparoscopically and significantly knowledgeable about adrenal 2002;16:100-02.
anatomy may be able to perform this operation in a hospital that 14. Kim AW, Quiros RM, Maxhimer JB, et al. Outcome of
offers an appropriate level of anesthesia and ICU care. laparoscopic adrenalectomy for pheochromocytomas vs
aldosteronomas. Arch Surg 2004;139:526-29; discussion 529-
CONCLUSION 31.
15. Li ML, Fitzgerald PA, Price DC, et al. Iatrogenic
laparoscopic resection of bening adrenal tumors can be pheochromocytomatosis: A previously unreported result of
performed safely with a short hospital stay and few laparoscopic adrenalectomy. Surgery 2001;130:1072-77.
complications; minimally invasive adrenalectomy for large 16. Inabnet WB, Pitre J, Bernard D, et al. Comparison of the
tumors has historically been controversial. Lesions larger than hemodynamic parameters of open and laparoscopic
adrenalectomy for pheochromocytoma. World J Surg
6 cm are associated with longer operative times than smaller 2000;24:574-78.
lesions, but they are not associated with greater blood loss, 17. Staren ED, Prinz RA. Adrenalectomy in the era of laparoscopy.
higher rates of intraoperative hemodynamic instability, or longer Surgery 1996;120:706-709; discussion 710-11.
hospital stay. 18. Walz MK, Peitgen K, Hoermann R, Giebler RM, Mann K,
Eigler FW. Posterior regroperitoneoscopy as a new minimally
REFERENCES invasive approach for adrenalectomy: Results of 30
adrenalectomies in 27 patients. Word J Surg 1996;20:769-74.
1. Heniford BT, Arca MJ, Walsh RM, Gill IS. Laparoscopic 19. Bonjer HJ, Lange JF, Kazemier G, deHerder WW, Steyerberg
adrenalectomy for cancer. Semin Surg Oncol 1999;16:293-06. EW, Bruining HA. Comparison of three techniques for
2. Gagner M, Pomp A, Heniford BT, et al. Laparoscopic adrenalectomy. Br J Surg 1997;84:679-83.
adrenalectomy: Lessons learned from 100 consecutive 20. Ross NS, Aron DC. Hormonal evaluation of a patient with an
procedures. Ann Surg 1997;226:238-46; discussion 246-47. incidentally discovered adrenal mass. N Engl J Med
3. Brunt LM. The positive impact of laparoscopic adrenalectomy 1990;323:1401-07.
on complications of adrenal surgery. Surg Endosc 2002;16:252- 21. Page DL, DeLellis RA, Hough AJ. Tumors of the adrenal. In:
57. HartmannWH, Cowan WR (Eds). Atlas of Tumor Pathology.
4. Jacobs JK, Goldstein RE, Geer RJ. Laparoscopic adrenalectomy: Washington Armed Forces Institute of Pathology 1986;1-06.
A new standard of care. Ann Surg 1997;225:495-01; discussion 22. Soper NJ, Brunt LM, Kerbl K. Laparoscopic general surgery,
501-02. 1994.
5. Werbel SS, Ober KP. Pheochromocytoma: Update on diagnosis, 23. Duh QY, Siperstein AE, Clark OH, et al. Laparoscopic
adrenalectomy:Comparison of the lateral and posterior
localization, and management. Med Clin North Am 1995;79:131- approaches. Arch Surg 1996;131:870-76.
53. 24. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in
6. Flavio Rocha M, Faramarzi-Roques R, Tauzin-Fin P, et al. Cushing’s syndrome and pheochromocytoma. N Engl J Med
Laparoscopic surgery for pheochromocytoma. Eur Urol 1992;327:1033.
2004;45:226-32. 25. Thompson GB, Grant CS, van Heerden J, et al. Laparoscopic
7. Fernandez-Cruz L, Saenz A, Taura P, et al. Helium and carbon versus open posterior adrenalectomy: A case-control study of
dioxide pneumoperitoneum in patients with pheochromocytoma 100 patients. Surg 1997;6:132-36.
undergoing laparoscopic adrenalectomy. World J Surg 26. Prinz RA. A comparison of laparoscopic and open
1998;22:1250-55. adrenalectomies. Arch Surg 1995;130:489-94.
8. Marty J, Desmonts JM, Chalaux G, et al. Hypertensive 27. Brunt LM, Doherty GM, Norton JA, Soper NJ, Quasebarth
responses during operation for phaeochromocytoma: A study MA, et al. Laparoscopic adrenalectomy compared to open
of plasma catecholamine and haemodynamic changes. Eur J adrenalectomy for benignadrenal neoplasms. J Am Coll Surg
Anaesthesiol 1985;2:257-64. 1996;183:1-10.

22
JAYPEE