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Posterior Retroperitoneoscopic Resection of Extra-adrenal Paraganglioma Located in the Aorto-caval Space

Authors
 Sang-Wook Kang  ;  Emad Kandil  ;  Min Jhi Kim  ;  Kwang Soon Kim  ;  Cho Rok Lee  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung  ;  Cheong Soo Park 
Citation
 Annals of Surgical Oncology, Vol.25(4) : 963, 2018 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2018
Abstract
BACKGROUND: The posterior retroperitoneoscopic adrenalec tomy has several advantages compared with the transperitoneal approach such as a shorter and more direct route to the target organ, no breach of the intraperitoneal space, and no required retraction of the adjacent organs. It also is a safe procedure with a short learning curve.1-5 This report presents a challenging case of an extra-adrenal paraganglioma located in the aorto-caval space and managed using the retroperitoneal approach. METHODS: A 39-year-old man was placed in the prone jackknife position, and three incisions were made in the right posterior abdominal wall for placement of the laparoscopic ports. The retroperitoneal space was entered with diathermy and blunt finger dissection, and retropneumoperitoneum was achieved with carbon dioxide insufflation pressure up to 18 mmHg. After identification of the right kidney and vessels, the tumor was meticulously dissected and excised with an energy device. The specimen was removed using a laparoscopic specimen retrieval bag, and the port sites were closed in layers. RESULTS: The operative time was 130 min, and the total blood loss was 30 ml. The tumor was diagnosed as a moderately differentiated extra-adrenal paraganglioma. The Von Hippel-Lindau gene mutation was detected using next-generation sequencing. CONCLUSIONS: The posterior retroperitoneoscopic approach is a safe, feasible, and effective method for excising an extra-adrenal paraganglioma even in the aorto-caval space. The authors suggest that this procedure is a useful surgical option for treatment of an aorto-caval paraganglioma for selected patients and by experienced surgeons.
Full Text
https://link.springer.com/article/10.1245%2Fs10434-017-6285-5
DOI
10.1245/s10434-017-6285-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강상욱(Kang, Sang Wook) ORCID logo https://orcid.org/0000-0001-5355-833X
김광순(Kim, Kwang Soon)
김민지(Kim, Min Jhi)
남기현(Nam, Kee Hyun) ORCID logo https://orcid.org/0000-0002-6852-1190
박정수(Park, Cheong Soo)
이초록(Lee, Cho Rok) ORCID logo https://orcid.org/0000-0001-7848-3709
정웅윤(Chung, Woung Youn)
정종주(Jeong, Jong Ju) ORCID logo https://orcid.org/0000-0002-4155-6035
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163751
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