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Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports

INTRODUCTION: Surgical manipulation of a pheochromocytoma carries the risk of releasing catecholamines into bloodstream leading to severe intraoperative hypertension. CASE PRESENTATION: We present three patients with right adrenal pheochromocytoma over 10 cm diameter: a 40‐year‐old woman, 63‐year‐ol...

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Autores principales: Ochi, Atsuhiko, Fan, Bo, Kimura, Natsuo, Watanabe, Hisaki, Toki, Sari, Fukuokaya, Wataru, Okada, Daigo, Aikawa, Koichi, Huang, Tingwen, Suzuki, Koichiro, Shiga, Naoki, Kitagawa, Yasuhide, Abe, Hirokazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292064/
https://www.ncbi.nlm.nih.gov/pubmed/32743363
http://dx.doi.org/10.1002/iju5.12027
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author Ochi, Atsuhiko
Fan, Bo
Kimura, Natsuo
Watanabe, Hisaki
Toki, Sari
Fukuokaya, Wataru
Okada, Daigo
Aikawa, Koichi
Huang, Tingwen
Suzuki, Koichiro
Shiga, Naoki
Kitagawa, Yasuhide
Abe, Hirokazu
author_facet Ochi, Atsuhiko
Fan, Bo
Kimura, Natsuo
Watanabe, Hisaki
Toki, Sari
Fukuokaya, Wataru
Okada, Daigo
Aikawa, Koichi
Huang, Tingwen
Suzuki, Koichiro
Shiga, Naoki
Kitagawa, Yasuhide
Abe, Hirokazu
author_sort Ochi, Atsuhiko
collection PubMed
description INTRODUCTION: Surgical manipulation of a pheochromocytoma carries the risk of releasing catecholamines into bloodstream leading to severe intraoperative hypertension. CASE PRESENTATION: We present three patients with right adrenal pheochromocytoma over 10 cm diameter: a 40‐year‐old woman, 63‐year‐old man, and 66‐year‐old woman. They were diagnosed by 123I‐MIBG scintigraphy and received preoperative antihypertensive treatment with 16 mg/day of doxazosin. Open adrenalectomy was performed with early right adrenal artery ligation between the inferior vena cava and ventral aorta (Step 1) as well as between the tumor and upper pole of the right kidney (Step 2). There was no severe intraoperative hypertension, and no recurrence was observed over 33 months, postoperatively. CONCLUSION: Early adrenal artery ligation may stop tumor blood supply and significantly reduce the catecholamine release. Our technique was thought to be safe and useful for preventing severe intraoperative hypertension in giant right adrenal pheochromocytoma.
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spelling pubmed-72920642020-07-30 Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports Ochi, Atsuhiko Fan, Bo Kimura, Natsuo Watanabe, Hisaki Toki, Sari Fukuokaya, Wataru Okada, Daigo Aikawa, Koichi Huang, Tingwen Suzuki, Koichiro Shiga, Naoki Kitagawa, Yasuhide Abe, Hirokazu IJU Case Rep Case Reports INTRODUCTION: Surgical manipulation of a pheochromocytoma carries the risk of releasing catecholamines into bloodstream leading to severe intraoperative hypertension. CASE PRESENTATION: We present three patients with right adrenal pheochromocytoma over 10 cm diameter: a 40‐year‐old woman, 63‐year‐old man, and 66‐year‐old woman. They were diagnosed by 123I‐MIBG scintigraphy and received preoperative antihypertensive treatment with 16 mg/day of doxazosin. Open adrenalectomy was performed with early right adrenal artery ligation between the inferior vena cava and ventral aorta (Step 1) as well as between the tumor and upper pole of the right kidney (Step 2). There was no severe intraoperative hypertension, and no recurrence was observed over 33 months, postoperatively. CONCLUSION: Early adrenal artery ligation may stop tumor blood supply and significantly reduce the catecholamine release. Our technique was thought to be safe and useful for preventing severe intraoperative hypertension in giant right adrenal pheochromocytoma. John Wiley and Sons Inc. 2018-11-12 /pmc/articles/PMC7292064/ /pubmed/32743363 http://dx.doi.org/10.1002/iju5.12027 Text en © 2018 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Reports
Ochi, Atsuhiko
Fan, Bo
Kimura, Natsuo
Watanabe, Hisaki
Toki, Sari
Fukuokaya, Wataru
Okada, Daigo
Aikawa, Koichi
Huang, Tingwen
Suzuki, Koichiro
Shiga, Naoki
Kitagawa, Yasuhide
Abe, Hirokazu
Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title_full Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title_fullStr Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title_full_unstemmed Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title_short Two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: Three case reports
title_sort two‐step technique of early adrenal artery ligation in open adrenalectomy of giant right adrenal pheochromocytomas: three case reports
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292064/
https://www.ncbi.nlm.nih.gov/pubmed/32743363
http://dx.doi.org/10.1002/iju5.12027
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