AB134. Operation experience of complicated paraganglioma

Objective: To discuss the retroperitoneal laparoscopic surgery of complicated paraganglioma.

Methods: We analyzed 5 patients with complicated paraganglioma admitted in our hospital from 1997 to 2015 retrospectively. All the 5 patients had hypertension, and accompanied with paroxysmal elevation. Endocrine examination and CT, MRI were done before operation. The tumors were in sphere with diameters between 2.8 to 6.0 cm. All tumors located besides the renal hilum, and were adjacent to abdominal aorta, inferior vena cava, renal artery and vein, renal pelvis, duodenum and pancreas, which increase the difficulty of operation. After pre-operation preparations with ? receptor blocker to expand the capacity of vessel for 4 weeks, the tumors were excised with retroperitoneal laparoscopy under general anaesthesia. The key points to these operations were to refer to the imaging results, and use ultrasonic knife to separate the tumor through the area with less organs and vessels.

Results: All the 5 paragangliomas were excised completely, without any harm to the adjacent organs and vessels. The operation time ranged from 2 hours and 10 minutes to 3 hours and 30 minutes. The amount of bleeding was between 10 to 150 mL. No transfusion was needed. The pathology results of 5 tumors were all paraganglioma. After 4 months to 2 years following up, no recurrence of tumor was found, and the blood pressure remind stable.

Conclusions: Retroperitoneal laparoscopic operation has more advantages compared with trans-abdominal laparoscopy, with less damages and side effects. Reaching the surface of tumor firstly and then beginning to separate the tumor is a safe, efficient and reliable method for complicated paraganglioma.

Keywords: Paraganglioma; operation; laparoscopic; retroperitoneal