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Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches

 Eun Jeong Ban  ;  Zeng Yap  ;  Emad Kandil  ;  Cho Rok Lee  ;  Sang-Wook Kang  ;  Jandee Lee  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung 
 MEDICINE, Vol.99(7) : e19104, 2020 
Journal Title
Issue Date
Adrenal Gland Neoplasms/pathology ; Adrenal Gland Neoplasms/surgery* ; Adrenalectomy/methods* ; Adult ; Blood Loss, Surgical/statistics & numerical data ; Blood Pressure ; Case-Control Studies ; Endoscopy ; Humans ; Length of Stay/statistics & numerical data ; Middle Aged ; Operative Time ; Pheochromocytoma/pathology ; Pheochromocytoma/surgery* ; Retroperitoneal Space/surgery ; Retrospective Studies
Hemodynamic stability is one of the most critical aspects of adrenal surgery for pheochromocytoma. Few articles have evaluated the hemodynamic status of patients undergoing posterior retroperitoneal adrenalectomy (PRA) for pheochromocytoma. The aim of this study is to compare the intraoperative hemodynamic parameters between lateral transperitoneal adrenalectomy (TPA) and PRA in this groups of patients.This report describes a retrospective study of 53 pheochromocytoma patients who underwent endoscopic adrenalectomy via transperitoneal (22 patients) or posterior retroperitoneal (31 patients) approaches from January 2008 to March 2015. Data from these patients were compared to investigate the differences in hemodynamic parameters between the 2 approaches.Clinical parameters at presentation were similar between the 2 groups, except for tumor size, which was larger in the TPA group. The PRA group is associated with reduced operative time, blood loss, and length of hospital stay compared to TPA even after adjusting for the tumor size. There was greater BP fluctuations and higher maximum systolic and diastolic blood pressure (BP) within the TPA group compared to PRA during univariate analysis. This was however not significant after adjusting for tumor size. There was no difference in the intraoperative inotropic support requirement between the 2 groups.PRA is associated with stable intraoperative hemodynamic status, as well as favorable perioperative outcomes compared to TPA in patients with small pheochromocytomas.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Ban, Eun Jeong(반은정)
Lee, Jan Dee(이잔디) ORCID logo https://orcid.org/0000-0003-4090-0049
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
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