Pheochromocytoma does not increase risk in laparoscopic adrenalectomy

Peter Nau, Sebastian Demyttenaere, Peter Muscarella, Vimal Narula, Jeffrey W. Hazey, E. Christopher Ellison, W. Scott Melvin

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Laparoscopic adrenalectomy (LA) has become the standard approach to an adrenal mass. This technique provides for decreased convalescence, less postoperative pain, and improved cosmesis. The use of LA for pheochromocytoma (PHE) has been questioned due to concerns of increased morbidity and negative hemodynamic sequelae. This study aimed to compare the outcomes of LA for PHE with the results of LA for other adrenal pathologies. Methods: A retrospective chart review was performed for an 11-year period from July 1997 to December 2008. Patient demographics, perioperative data, and outcomes were recorded. Statistical analysis was performed using SPSS 16.0. Statistical significance was defined as a p value less than 0.05. Results: A total of 102 LA procedures were completed for 95 patients. The data for 33 PHE cases were compared with the data for 69 non-PHE cases (26 adenomas, 14 aldosteronomas, 5 cortisol-secreting tumors, 5 multinodular hyperplasias, and 19 other disorders). Five LA procedures were converted to open surgery. Four of these conversions involved patients with PHE (p = 0.03). There was no difference in the mean estimated blood loss (p = 0.2) or operative time (p = 0.1) between the two groups. The frequency of intraoperative hypertension and hypotension did not differ between the PHE and non-PHE cohorts. The complication rate was 7.5% for the PHE group and 6.9% for the non-PHE group (p = 0.7). The patients with PHE had a longer postoperative hospital stay (3.6 vs 2.3 days; p < 0.001) and overall hospital stay (4.9 vs 2.6 days; p < 0.001). Time in the intensive care unit (1.1 vs 0.1 days; p < 0.001) and time until oral intake (1.5 vs 1.0 days; p = 0.02) also were increased in the PHE population. There was one death in the PHE group secondary to congestive heart failure. Conclusions: Concerns of increased morbidity related to a laparoscopic approach for patients with a diagnosis of PHE are unfounded. In this series, the only disparity in outcomes between the two groups was an increased conversion rate with PHE.

Original languageEnglish (US)
Pages (from-to)2760-2764
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume24
Issue number11
DOIs
StatePublished - Nov 2010
Externally publishedYes

Fingerprint

Adrenalectomy
Pheochromocytoma
Length of Stay
Morbidity
Operative Time
Postoperative Pain
Adenoma
Hypotension
Hyperplasia
Intensive Care Units
Hydrocortisone
Heart Failure
Hemodynamics
Demography
Pathology
Hypertension

Keywords

  • Adrenalectomy
  • Laparoscopic surgery
  • Laparoscopy
  • Pheochromocytoma

ASJC Scopus subject areas

  • Surgery

Cite this

Pheochromocytoma does not increase risk in laparoscopic adrenalectomy. / Nau, Peter; Demyttenaere, Sebastian; Muscarella, Peter; Narula, Vimal; Hazey, Jeffrey W.; Ellison, E. Christopher; Melvin, W. Scott.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 24, No. 11, 11.2010, p. 2760-2764.

Research output: Contribution to journalArticle

Nau, Peter ; Demyttenaere, Sebastian ; Muscarella, Peter ; Narula, Vimal ; Hazey, Jeffrey W. ; Ellison, E. Christopher ; Melvin, W. Scott. / Pheochromocytoma does not increase risk in laparoscopic adrenalectomy. In: Surgical Endoscopy and Other Interventional Techniques. 2010 ; Vol. 24, No. 11. pp. 2760-2764.
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abstract = "Background: Laparoscopic adrenalectomy (LA) has become the standard approach to an adrenal mass. This technique provides for decreased convalescence, less postoperative pain, and improved cosmesis. The use of LA for pheochromocytoma (PHE) has been questioned due to concerns of increased morbidity and negative hemodynamic sequelae. This study aimed to compare the outcomes of LA for PHE with the results of LA for other adrenal pathologies. Methods: A retrospective chart review was performed for an 11-year period from July 1997 to December 2008. Patient demographics, perioperative data, and outcomes were recorded. Statistical analysis was performed using SPSS 16.0. Statistical significance was defined as a p value less than 0.05. Results: A total of 102 LA procedures were completed for 95 patients. The data for 33 PHE cases were compared with the data for 69 non-PHE cases (26 adenomas, 14 aldosteronomas, 5 cortisol-secreting tumors, 5 multinodular hyperplasias, and 19 other disorders). Five LA procedures were converted to open surgery. Four of these conversions involved patients with PHE (p = 0.03). There was no difference in the mean estimated blood loss (p = 0.2) or operative time (p = 0.1) between the two groups. The frequency of intraoperative hypertension and hypotension did not differ between the PHE and non-PHE cohorts. The complication rate was 7.5{\%} for the PHE group and 6.9{\%} for the non-PHE group (p = 0.7). The patients with PHE had a longer postoperative hospital stay (3.6 vs 2.3 days; p < 0.001) and overall hospital stay (4.9 vs 2.6 days; p < 0.001). Time in the intensive care unit (1.1 vs 0.1 days; p < 0.001) and time until oral intake (1.5 vs 1.0 days; p = 0.02) also were increased in the PHE population. There was one death in the PHE group secondary to congestive heart failure. Conclusions: Concerns of increased morbidity related to a laparoscopic approach for patients with a diagnosis of PHE are unfounded. In this series, the only disparity in outcomes between the two groups was an increased conversion rate with PHE.",
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T1 - Pheochromocytoma does not increase risk in laparoscopic adrenalectomy

AU - Nau, Peter

AU - Demyttenaere, Sebastian

AU - Muscarella, Peter

AU - Narula, Vimal

AU - Hazey, Jeffrey W.

AU - Ellison, E. Christopher

AU - Melvin, W. Scott

PY - 2010/11

Y1 - 2010/11

N2 - Background: Laparoscopic adrenalectomy (LA) has become the standard approach to an adrenal mass. This technique provides for decreased convalescence, less postoperative pain, and improved cosmesis. The use of LA for pheochromocytoma (PHE) has been questioned due to concerns of increased morbidity and negative hemodynamic sequelae. This study aimed to compare the outcomes of LA for PHE with the results of LA for other adrenal pathologies. Methods: A retrospective chart review was performed for an 11-year period from July 1997 to December 2008. Patient demographics, perioperative data, and outcomes were recorded. Statistical analysis was performed using SPSS 16.0. Statistical significance was defined as a p value less than 0.05. Results: A total of 102 LA procedures were completed for 95 patients. The data for 33 PHE cases were compared with the data for 69 non-PHE cases (26 adenomas, 14 aldosteronomas, 5 cortisol-secreting tumors, 5 multinodular hyperplasias, and 19 other disorders). Five LA procedures were converted to open surgery. Four of these conversions involved patients with PHE (p = 0.03). There was no difference in the mean estimated blood loss (p = 0.2) or operative time (p = 0.1) between the two groups. The frequency of intraoperative hypertension and hypotension did not differ between the PHE and non-PHE cohorts. The complication rate was 7.5% for the PHE group and 6.9% for the non-PHE group (p = 0.7). The patients with PHE had a longer postoperative hospital stay (3.6 vs 2.3 days; p < 0.001) and overall hospital stay (4.9 vs 2.6 days; p < 0.001). Time in the intensive care unit (1.1 vs 0.1 days; p < 0.001) and time until oral intake (1.5 vs 1.0 days; p = 0.02) also were increased in the PHE population. There was one death in the PHE group secondary to congestive heart failure. Conclusions: Concerns of increased morbidity related to a laparoscopic approach for patients with a diagnosis of PHE are unfounded. In this series, the only disparity in outcomes between the two groups was an increased conversion rate with PHE.

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