title: One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy.
abstract: 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.
authors.affiliation: University of California-San Francisco/Mount Zion Medical Center, 1600 Divisadero Street, San Francisco, CA 94115, USA. wen.shen@ucsfmedctr.org
authors.forename: Wen T
authors.initials: WT
authors.lastname: Shen
authors.forename: Raymon
authors.initials: R
authors.lastname: Grogan
authors.forename: Menno
authors.initials: M
authors.lastname: Vriens
authors.forename: Orlo H
authors.initials: OH
authors.lastname: Clark
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
mesh_terms: 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