One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy.
OBJECTIVE
Pheochromocytoma can be safely treated laparoscopically; "subclinical" pheochromocytoma is increasingly common.


METHODS
Retrospective review.


METHODS
University hospital.


METHODS
Patients undergoing adrenalectomy for pheochromocytoma at our institution in 1994 to 2009.


METHODS
Laparoscopic, hand-assisted, and open adrenalectomy.


METHODS
Preoperative and postoperative clinical and biochemical data.


RESULTS
One hundred two patients (52 women, 50 men) with pheochromocytoma underwent 108 operations. Ninety-seven operations were laparoscopic; 7, open; and 4, converted from laparoscopic to hand assisted or open. Six operations were bilateral; 3 were subtotal cortex-sparing resections. Thirty-four patients (33%) presented with adrenal incidentaloma and minimal symptoms, 28 within the past decade. Ten patients had paragangliomas, 7 of whom underwent laparoscopic resection. The mean (SD) tumor size was 5.3 (2.8) cm. Seven patients had recurrence requiring reoperation; the mean length of time between initial operation and recurrence was 6 years (range, 6 months to 17 years). There were no perioperative deaths.


CONCLUSIONS
Laparoscopic adrenalectomy can be safely performed for pheochromocytoma in more than 90% of cases. More than one-third of patients presented with subclinical pheochromocytoma. Patients should be followed up closely because recurrence may develop several years after adrenalectomy.
Shen
Wen T
WT
University of California-San Francisco/Mount Zion Medical Center, 1600 Divisadero Street, San Francisco, CA 94115, USA. wen.shen@ucsfmedctr.org
Grogan
Raymon
R
Vriens
Menno
M
Clark
Orlo H
OH
Duh
Quan-Yang
QY
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007423:Intra-Aortic Balloon Pumping; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010673:Pheochromocytoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000453:epidemiology / Q000628:therapy