Laparoscopic adrenalectomy for large unilateral pheochromocytoma

Experience in a large academic medical center

Kyle A. Perry, Raphael El Youssef, Thai H. Pham, Brett Sheppard

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.

Original languageEnglish (US)
Pages (from-to)1462-1467
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume24
Issue number6
DOIs
StatePublished - Jun 2010

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Adrenalectomy
Pheochromocytoma
Hemodynamics
Operative Time
Recurrence
Neoplasms
Dissection
Length of Stay
Outcome Assessment (Health Care)
Therapeutics

Keywords

  • Adrenalectomy
  • Laparoscopic adrenalectomy
  • Laparoscopy
  • Pheochromocytoma

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

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title = "Laparoscopic adrenalectomy for large unilateral pheochromocytoma: Experience in a large academic medical center",
abstract = "Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7{\%} of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.",
keywords = "Adrenalectomy, Laparoscopic adrenalectomy, Laparoscopy, Pheochromocytoma",
author = "Perry, {Kyle A.} and {El Youssef}, Raphael and Pham, {Thai H.} and Brett Sheppard",
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pages = "1462--1467",
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TY - JOUR

T1 - Laparoscopic adrenalectomy for large unilateral pheochromocytoma

T2 - Experience in a large academic medical center

AU - Perry, Kyle A.

AU - El Youssef, Raphael

AU - Pham, Thai H.

AU - Sheppard, Brett

PY - 2010/6

Y1 - 2010/6

N2 - Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.

AB - Background Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage. Methods Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size. Results Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group. Conclusions Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.

KW - Adrenalectomy

KW - Laparoscopic adrenalectomy

KW - Laparoscopy

KW - Pheochromocytoma

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