title: Retroperitoneoscopic resection of primary paraganglioma: single-center clinical experience and literature review.
abstract: OBJECTIVE
  Paraganglioma (PG) is a rare neuroendocrine entity. Surgical resection is recommended as the mainstay of treatment due to the uncontrolled hypertension, close proximity to major vessels, variable location, and higher potential malignancy. With rapid development of minimally invasive techniques during the past decade, laparoscopic resection of retroperitoneal PG has been reported with successful results. There are only a few publications describing retroperitoneal access, however. In the present study, we proposed to summarize our experience on retroperitoneal laparoscopic resection in 10 patients and systematically review relevant publications to evaluate its safety and efficacy.
  
  
  METHODS
  From June 2009 to October 2013, 10 patients with PG who were treated with retroperitoneoscopy were included in the study. Minimal effective dosage α-blockade with phenoxybenzamine was routinely used. Preoperative, intraoperative, and postoperative baseline data were collected and analyzed. Meanwhile, two reviewers independently searched and identified 8 retrospective studies and 23 case reports in the Medline, Embase, and Science Citation Index between 1998 and 2013.
  
  
  RESULTS
  Operations in 9 of 10 patients were successfully completed without conversion; one case was converted to open surgery because of left accessory renal artery injury. Mean operative time, blood loss, and postoperative hospital stay were 97.8±20.6 minutes, 44.4±8.2 mL, and 4.8±3.5 days, respectively. There were three complications in this series, including accessory renal artery injury, renal vein injury, and chylorrhea.
  
  
  CONCLUSIONS
  Retroperitoneoscopic resection is feasible, effective, and safe in the treatment of patients with PG according to our preliminary clinical experience and has distinct advantages including direct access to the tumor, less intraperitoneal interference, precise dissection, and minimal invasiveness.
authors: 1 The Second Urological Department, Gansu Nephro-Urological Clinical Center, The Second Hospital of Lanzhou University , Lanzhou, China .
authors: Jiaji
authors: J
authors: Wang
authors: Yi
authors: Y
authors: Li
authors: Nan
authors: N
authors: Xiao
authors: Jianmin
authors: J
authors: Duan
authors: Ninqiang
authors: N
authors: Yang
authors: Junsheng
authors: J
authors: Bao
authors: Ye
authors: Y
authors: Li
authors: Jun
authors: J
authors: Mi
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D010235:Paraganglioma / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012186:Retroperitoneal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies