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

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 hemo...

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Autores principales: Ban, Eun Jeong, Yap, Zeng, Kandil, Emad, Lee, Cho Rok, Kang, Sang-Wook, Lee, Jandee, Jeong, Jong Ju, Nam, Kee-Hyun, Chung, Woong Youn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035043/
https://www.ncbi.nlm.nih.gov/pubmed/32049819
http://dx.doi.org/10.1097/MD.0000000000019104
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author Ban, Eun Jeong
Yap, Zeng
Kandil, Emad
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
author_facet Ban, Eun Jeong
Yap, Zeng
Kandil, Emad
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
author_sort Ban, Eun Jeong
collection PubMed
description 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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spelling pubmed-70350432020-03-10 Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches Ban, Eun Jeong Yap, Zeng Kandil, Emad Lee, Cho Rok Kang, Sang-Wook Lee, Jandee Jeong, Jong Ju Nam, Kee-Hyun Chung, Woong Youn Medicine (Baltimore) 7100 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. Wolters Kluwer Health 2020-02-14 /pmc/articles/PMC7035043/ /pubmed/32049819 http://dx.doi.org/10.1097/MD.0000000000019104 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Ban, Eun Jeong
Yap, Zeng
Kandil, Emad
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title_full Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title_fullStr Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title_full_unstemmed Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title_short Hemodynamic stability during adrenalectomy for pheochromocytoma: A case control study of posterior retroperitoneal vs lateral transperitoneal approaches
title_sort hemodynamic stability during adrenalectomy for pheochromocytoma: a case control study of posterior retroperitoneal vs lateral transperitoneal approaches
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035043/
https://www.ncbi.nlm.nih.gov/pubmed/32049819
http://dx.doi.org/10.1097/MD.0000000000019104
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