Abstract
ObjectivesTo explore the feasibility and safety of retroperitoneal laparoscopic resection of paraganglioma (RLPG) in a large study population.MethodsIn a six-year period, 49 patients with primary retroperitoneal paragangliomas (PG) underwent retroperitoneal laparoscopic surgery in a single center. Medical records were reviewed, and collected the following data, which were clinical characteristics, perioperative data (operative time, estimated blood loss, intraoperative hemodynamic changes, intraoperative and postoperative complications, and open conversions), and follow-up data (recurrence or distant metastases).ResultsAll PGs were removed with negative tumor margin confirmed by postoperative histopathology. The operative time of RLPG was 101.59±31.12 minutes, and the estimated blood loss was 169.78±176.70ml. Intraoperative hypertensive and hypotensive episodes occurred in 25 cases and 27 cases, respectively. Two open conversions occurred. Two intraoperative complications occurred but were successfully managed endoscopically. Postoperative complications were minor and unremarkable. No local recurrence or distant metastasis were observed during the follow-up period.ConclusionsOur experience indicates the feasibility and safety of resection of PGs in a relatively large study population.
Highlights
Paraganglioma (PG), known as extra-adrenal pheochromocytoma, is a chromaffin cell tumor located at various sites along the sympathetic/parasympathetic chain, ranging in incidence from 0.005% to 0.1% in the general population[1]
More than 85% of the PGs occur below the diaphragm and most of them are functional, with symptoms and signs of catecholamine overproduction, similar to pheochromocytoma (PCC) except for the variation in the anatomic location[2, 3]
We presented our experience of RLPG in a relatively large study population, and explored its feasibility, safety, and surgical outcomes
Summary
Paraganglioma (PG), known as extra-adrenal pheochromocytoma, is a chromaffin cell tumor located at various sites along the sympathetic/parasympathetic chain, ranging in incidence from 0.005% to 0.1% in the general population[1]. More than 85% of the PGs occur below the diaphragm and most of them are functional, with symptoms and signs of catecholamine overproduction, similar to pheochromocytoma (PCC) except for the variation in the anatomic location[2, 3]. Open exploration and resection is the standard surgical management of PG, laparoscopic resection of PG is considered challenging because of the altered anatomic location, dense peritumoral adhesions, high vascularity envelope, and proximity to major blood vessels. To the best of our knowledge, most of these studies reported successful removal of PGs, but simultaneously found longer operative time and higher incidence of complications compared with PCC[13,14,15]
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