The application of new technique in retroperitoneal adrenalectomy based on the new acknowledge of morbid anatomy regarding feeding vessels in large pheochromocytoma
Cai Wei1, Guo Gang1, Li Hongzhao1, Zhu Qing1, Yu Hongkai1, Zhang Xu1
1Department of Urology, Chinese PLA General Hospital,Beijing,100853,China
Abstract：Objective:To evaluate the feasibility and safety of the new technique in retroperitoneal adrenalectomy based on the new acknowledge of morbid anatomy in large pheochromocytoma.Methods:The criteria of the candidates is that the maximal diameter of the adrenal tumor is more than 6 cm indicated in the preoperative CT or MRI scans. Of 9 patients, 3 were male and 6 were female. The age ranged 31-52 years old. Based on the new acknowledge of morbid anatomy in large pheochromocytoma originating from the retrospective study of 22 cases retroperitoneal adrenalectomy surgical videos, we employed a new surgical technique in the retroperitoneal adrenalectomy for large pheochromocytoma. The perioperative perimeter including operating times, estimated blood loss, tumor size, gland weight, histopathology, open convention, severe perioperative complication, postoperative hospital stay were recorded.Results:The retroperitoneal laparoscopic adrenalectomies were successfully performed in all but no case, which was converted to open surgery. Mean operative time was 90 mins (60-110 mins)and mean estimated blood loss was 74 ml(50-200 ml).Severe postoperative complications were not observed. The postoperative hospital stays ranged 3-5 days. Tumor size ranged 6-10 cm. The pathology showed the pheochromocytoma in all cases.Conclusions:Basic vessels of tumor turn to hyperplasia, disorder, enlarge; The surface vessels of tumor are spider web looking. The feeding vessels of tumor are from the triangle area of tumor base. Modification of zhang’s three planes technique made the expose of tumor base easy and fasciculate dissection of basic vessels make the control of vessels safe, precise, feasible. The new technique in retroperitoneal adrenalectomy based on the new acknowledge of morbid anatomy in large pheochromocytoma is feasible and safe.
蔡伟, 郭刚, 李宏召, 祝强, 俞鸿凯, 张旭. 大嗜铬细胞瘤营养血管病理解剖的认识及后腹腔镜解剖性切除的手术技巧[J]. 微创泌尿外科杂志, 2013, 2(2): 88-91.
Cai Wei, Guo Gang, Li Hongzhao, Zhu Qing, Yu Hongkai, Zhang Xu. The application of new technique in retroperitoneal adrenalectomy based on the new acknowledge of morbid anatomy regarding feeding vessels in large pheochromocytoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(2): 88-91.
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