{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:16:34Z","timestamp":1789881394180,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials<\/jats:title><jats:p>In the setting of a prospective study (1\/2001\u201312\/2016), 42 consecutive children and adolescents (33\u00a0m, 9 f) were operated on. Thirty\u2010seven patients (88%) suffered from inherited diseases. Twenty\u2010six patients had PH, 11 presented retroperitoneal PGL, and five patients suffered from both. Altogether, 70 tumours (mean size 2.7\u00a0cm) were removed (45\u00a0PH, 25\u00a0PGL). All operations were performed by a minimally invasive access (retroperitoneoscopic, laparoscopic, extraperitoneal). Partial adrenalectomy was the preferred procedure for PH (31 out of 39 patients). Twenty patients received \u03b1\u2010receptor blockade preoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One patient died after induction of anaesthesia due to cardiac arrest. All other complications were minor. Conversion to open surgery was necessary in two cases with PGL. Median operating time for unilateral PH was 55\u00a0min, in bilateral cases 125, 143\u00a0min in PGs, and 180\u00a0min in combined cases. Median blood loss was 20\u00a0ml (range 0\u20131000). Blood transfusion was necessary in two cases. Intraoperative, systolic peak pressure was 170 \u00b1 39\u00a0mmHg with \u03b1\u2010receptor blockade and 191 \u00b1 33\u00a0mmHg without \u03b1\u2010receptor blockade (<jats:italic>p<\/jats:italic> = 0.41). The median post\u2010operative hospital stay was 3\u00a0days. After a mean follow\u2010up of 8.5 years, two patients presented ipsilateral recurrence (after partial adrenalectomy). All patients with bilateral PH (<jats:italic>n<\/jats:italic> = 13) are steroid independent post\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PH and PGL in children and adolescents should preferably be removed by minimally invasive surgery. Partial adrenalectomy provides long\u2010term steroid independence in bilateral PH and a low rate of (ipsilateral) recurrence. \u03b1\u2010Receptor blockade may not be necessary in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4488-y","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T15:31:04Z","timestamp":1517499064000},"page":"1024-1030","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Minimally Invasive Surgery (MIS) in Children and Adolescents with Pheochromocytomas and Retroperitoneal Paragangliomas: Experiences in 42\u00a0Patients"],"prefix":"10.1002","volume":"42","author":[{"given":"Martin K.","family":"Walz","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Chirurgie und Zentrum f\u00fcr Minimal Invasive Chirurgie Kliniken Essen\u2010Mitte Henricistrasse 92 45136 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura D.","family":"Iova","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Chirurgie und Zentrum f\u00fcr Minimal Invasive Chirurgie Kliniken Essen\u2010Mitte Henricistrasse 92 45136 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Deimel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Chirurgie und Zentrum f\u00fcr Minimal Invasive Chirurgie Kliniken Essen\u2010Mitte Henricistrasse 92 45136 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut P. H.","family":"Neumann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin IV, Universit\u00e4tsklinikum Freiburg, Medizinische Fakult\u00e4t Albert\u2010Ludwigs\u2010Universit\u00e4t Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birke","family":"Bausch","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin II, Universit\u00e4tsklinikum Freiburg, Medizinische Fakult\u00e4t Albert\u2010Ludwigs\u2010Universit\u00e4t Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zschiedrich","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin IV, Universit\u00e4tsklinikum Freiburg, Medizinische Fakult\u00e4t Albert\u2010Ludwigs\u2010Universit\u00e4t Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Groeben","sequence":"additional","affiliation":[{"name":"Klinik 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