title: Outcomes of resection of extra-adrenal pheochromocytomas/paragangliomas in the laparoscopic era: a comparison with adrenal pheochromocytoma.
abstract: BACKGROUND
  Laparoscopic adrenalectomy (LA) is the standard for removal of adrenal pheochromocytomas (pheos), but laparoscopic (LAP) resection of paragangliomas (PGs) is controversial. This study analyzes our results of resection of PGs in the LAP era.
  
  
  METHODS
  A retrospective record review of all patients who underwent resection of intra-abdominal PGs from 1998 to 2011 was performed. Pre- and postoperative clinical, radiologic, biochemical, and pathologic data for LAP resection of PGs were compared with patients who underwent LA for adrenal pheo (LA pheo; n = 62). Statistical analysis was performed and data are reported as mean ± SD.
  
  
  RESULTS
  Fifteen patients had resection of PGs (6 OPEN, 9 LAP) and 62 had LA pheo. Most common PG locations were perirenal or renal hilum (n = 6) and para-aortic (n = 4). One LAP PG was converted to OPEN due to inflammation from a prior biopsy. Mean age of LAP PGs was 45.3 ± 13.2 years, and mean tumor size was 3.3 ± 2.1 cm. OPEN PGs were larger (5.1 vs. 3.3 cm), had shorter operative times (173 vs. 254 min), and longer hospitalization (5.7 vs. 2.6 days) and ICU stays (1.33 vs. 0.22 days) compared with LAP PGs (p ≤ 0.05). Compared with LA pheo, operative times for LAP PG were significantly longer (254 vs. 175 min, p = 0.001) but other outcomes were similar. Complications occurred in 5.9 % of LA pheos, 22 % of LAP PGs and 67 % of OPEN PGs.
  
  
  CONCLUSIONS
  Patients with paragangliomas can safely benefit from LAP resection with outcomes similar to adrenal pheos. In the absence of a need for contiguous organ resection, LAP resection of paragangliomas seems to be the preferred surgical approach.
authors.affiliation: Department of Surgery, Institute for Minimally Invasive Surgery, Washington University School of Medicine, 660 S Euclid Ave., Box 8109, St. Louis, MO 63110, USA.
authors.forename: Trudie A
authors.initials: TA
authors.lastname: Goers
authors.forename: Michael
authors.initials: M
authors.lastname: Abdo
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Moley
authors.forename: Brent D
authors.initials: BD
authors.lastname: Matthews
authors.forename: Mary
authors.initials: M
authors.lastname: Quasebarth
authors.forename: L Michael
authors.initials: LM
authors.lastname: Brunt
mesh_terms: D000008:Abdominal Neoplasms / Q000601:surgery*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000601:surgery*; D010673:Pheochromocytoma / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult