Paraganglioma surgery: Difference between revisions

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{{Paraganglioma}}
{{Paraganglioma}}
{{CMG}} {{AE}} {{AAM}}
{{CMG}}; {{AE}}  
 
==Overview==
==Overview==
Surgery is the mainstay of treatment for paraganglioma.
Surgical intervention is not recommended for the management of [disease name].
 
OR
 
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
 
OR
 
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
 
OR
 
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
 
OR
 
Surgery is the mainstay of treatment for [disease or malignancy].
 
==Indications==
 
*Surgical intervention is not recommended for the management of [disease name].
OR
*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
 
==Surgery==
==Surgery==
*Paraganglioma is treated by [[surgical]] excision.
 
*Careful pre-operative preparation is required in order to prevent an intra-operative [[hypertensive crisis]], due to the massive release of [[catecholamine]] with tumor handling, or profound post-operative [[hypotension]] and massive fluid requirements resulting from the fluid shifts that follow [[catecholamine]] control.
*The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
*Pre-operative preparation is best undertaken with administration of [[alpha-blocker|alpha-adrenergic blocking agents]], such as [[phenoxybenzamine]].
OR
===Operative Management===
*Surgery is the mainstay of treatment for [disease or malignancy].
*[[Adrenalectomy]] can be performed either as an open procedure, as a [[laparoscopy|laparoscopic procedure]] with hand assist devices, or solely as a laparoscopic procedure.
 
*Increasingly, the accepted philosophy is to tailor the surgical approach to the tumor size and clinical situation.
==Contraindications==
*The open approach to the adrenal gland is either anteriorly through the [[peritoneal cavity]] (now used only for large and probably malignant lesions), or via an extraperitoneal approach, either posteriorly through the bed of the 12th rib or postero-laterally, or combined as a thoraco-abdominal procedure. These procedures should be used for very large tumors, or those known to be malignant.
*Laparoscopic adrenalectomy is associated with reduced post-operative pain, and allows the patient to leave hospital after 2 or 3 days.
===Complications of Surgery===
*Complications of [[adrenalectomy]] include all the general complications of any open abdominal [[adrenal]] operation or [[laparoscopic]] procedure such as [[bleeding]], wound infection and [[ileus]].


==References==
==References==
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{{Reflist|2}}
{{Epithelial neoplasms}}
 
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Latest revision as of 19:06, 31 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

  • Surgical intervention is not recommended for the management of [disease name].

OR

  • Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]
  • The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]

Surgery

  • The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

  • Surgery is the mainstay of treatment for [disease or malignancy].

Contraindications

References

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