title: Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma.
abstract: BACKGROUND
  Laparoscopic adrenalectomy (LA) is a safe minimally invasive approach for treatment of pheochromocytoma (PHEO). Posterior retroperitoneoscopic adrenalectomy (PRA) is an alternative minimally invasive technique; however, there is a lack of data regarding the appropriateness of this approach in patients with PHEO.
  
  
  METHODS
  Our endocrine surgery database was queried to identify patients who underwent LA or PRA for PHEO. Patient and tumor characteristics, as well as operative details and postoperative course were compared between the 2 groups.
  
  
  RESULTS
  LA or PRA was attempted in 46 patients with PHEO (23 LA, 23 PRA). There were no differences in age, BMI, or tumor size between these groups. PRA was associated with significantly reduced operative times (99 min vs 145 min, P < .001), estimated blood loss (8.4 cc vs 123.8 cc, P = .02), and postoperative length of stay (1.9 nights vs 3.1 nights, P < .01). There was no significant difference in rates of conversion to an open procedure or perioperative complications between these groups.
  
  
  CONCLUSIONS
  LA and PRA are both safe and effective approaches in patients with PHEO. In our experience, PRA results in decreased operative times, blood loss, and postoperative length of stay compared with LA. PRA has become our preferred approach for patients with PHEO.
authors: Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Paxton V
authors: PV
authors: Dickson
authors: Gillian C
authors: GC
authors: Alex
authors: Elizabeth G
authors: EG
authors: Grubbs
authors: Montserrat
authors: M
authors: Ayala-Ramirez
authors: Camilo
authors: C
authors: Jimenez
authors: Douglas B
authors: DB
authors: Evans
authors: Jeffrey E
authors: JE
authors: Lee
authors: Nancy D
authors: ND
authors: Perrier
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D010673:Pheochromocytoma / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology; D012187:Retroperitoneal Space / Q000601:surgery; D012189:Retrospective Studies; D017751:Safety Management; D016896:Treatment Outcome; D055815:Young Adult