open access

Vol 70, No 6 (2019)
Original paper
Published online: 2019-09-17
Submitted: 2019-05-08
Accepted: 2019-07-29
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Surgical treatment of abdominal paragangliomas

Sadegh Toutounchi, Małgorzata E. Legocka, Ryszard Pogorzelski, Łukasz Zapała, Ewa Krajewska, Krzysztof Celejewski, Urszula Ambroziak, Zbigniew Gałązka
DOI: 10.5603/EP.a2019.0038
·
Pubmed: 31529458
·
Endokrynologia Polska 2019;70(6):469-472.

open access

Vol 70, No 6 (2019)
Original Paper
Published online: 2019-09-17
Submitted: 2019-05-08
Accepted: 2019-07-29

Abstract

Introduction: Extraperitoneal, abdominal paragangliomas most commonly originate from the sympathetic nervous system. Typical features include catecholamine overproduction and the potential for malignancy. Lesions are usually located paravertebrally, but when growing in a more expansive manner they may also appear between the inferior vena cava and aorta. In the authors’ opinion this site excludes laparoscopic tumourectomy.

Material and methods: Twenty-eight patients were selected for surgical management of abdominal paragangliomas in the past eight years at our endocrine surgical centre. This group consisted of 21 (75%) women and seven (25%) men, aged 14 to 84 years (mean 47.9). In 13 (46.4%) cases paroxysmal hypertension was observed. Type 2 diabetes was noted in another 10 (35.7%) patients, and Takotsubo acute coronary syndrome in two (7.1%). Patients were preoperatively qualified for either open surgery or laparoscopic tumourectomy based on visualisation and location of the tumours in imaging studies.

Results: All patients were successfully operated. Eleven (39.3%) patients qualified for laparoscopy, while the remaining 17 (60.7%) were treated with an open surgical approach due to difficult access to the lesion. The mean operative time was 130 minutes for laparoscopy and 120 minutes for laparotomy (p = 0.2). There were no local or general complications after either type of procedure.

Conclusions: The use of laparoscopic access is practically excluded in the treatment of paragangliomas located between the inferior vena cava and aorta, especially at the level of the renal vessels and extending superiorly to the diaphragm. 

Abstract

Introduction: Extraperitoneal, abdominal paragangliomas most commonly originate from the sympathetic nervous system. Typical features include catecholamine overproduction and the potential for malignancy. Lesions are usually located paravertebrally, but when growing in a more expansive manner they may also appear between the inferior vena cava and aorta. In the authors’ opinion this site excludes laparoscopic tumourectomy.

Material and methods: Twenty-eight patients were selected for surgical management of abdominal paragangliomas in the past eight years at our endocrine surgical centre. This group consisted of 21 (75%) women and seven (25%) men, aged 14 to 84 years (mean 47.9). In 13 (46.4%) cases paroxysmal hypertension was observed. Type 2 diabetes was noted in another 10 (35.7%) patients, and Takotsubo acute coronary syndrome in two (7.1%). Patients were preoperatively qualified for either open surgery or laparoscopic tumourectomy based on visualisation and location of the tumours in imaging studies.

Results: All patients were successfully operated. Eleven (39.3%) patients qualified for laparoscopy, while the remaining 17 (60.7%) were treated with an open surgical approach due to difficult access to the lesion. The mean operative time was 130 minutes for laparoscopy and 120 minutes for laparotomy (p = 0.2). There were no local or general complications after either type of procedure.

Conclusions: The use of laparoscopic access is practically excluded in the treatment of paragangliomas located between the inferior vena cava and aorta, especially at the level of the renal vessels and extending superiorly to the diaphragm. 

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Keywords

paragangliomas; pheochromocytoma; surgery of paragangliomas

About this article
Title

Surgical treatment of abdominal paragangliomas

Journal

Endokrynologia Polska

Issue

Vol 70, No 6 (2019)

Article type

Original paper

Pages

469-472

Published online

2019-09-17

DOI

10.5603/EP.a2019.0038

Pubmed

31529458

Bibliographic record

Endokrynologia Polska 2019;70(6):469-472.

Keywords

paragangliomas
pheochromocytoma
surgery of paragangliomas

Authors

Sadegh Toutounchi
Małgorzata E. Legocka
Ryszard Pogorzelski
Łukasz Zapała
Ewa Krajewska
Krzysztof Celejewski
Urszula Ambroziak
Zbigniew Gałązka

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