title: Presentation and surgery outcomes in elderly with pheocromocytoma: a comparative analysis with Young patients.
abstract: OBJECTIVE
  To evaluate the presentation and early surgical outcomes of elderly patients undergoing adrenalectomy for phaeochromocytoma.
  
  
  METHODS
  A retrospective search was performed of our adrenal disorders database for patients who underwent surgery for phaeochromocytoma or paraganglioma between 2009 and 2014. Patients >60 years old were classified as elderly. The clinical manifestations, intraoperative course, and early postoperative outcomes of elderly patients were compared to those of younger individuals (<60 years old).
  
  
  RESULTS
  The mean (±standard deviation) age in the older (n=10) and younger (n=36) groups was 69.6±5.3 years and 34.0±12.9 years. Germ-line mutations were more common in younger patients (50.0% versus 0%; p=0.004), whereas incidental lesions were more common in the elderly (40.0% versus 5.3%; p=0.003). In both groups, surgery was most commonly performed by videolaparoscopy (90% in the elderly and 82% in the younger group), with similar intraoperative anesthetic and surgical outcomes. Postoperatively, the older group more commonly received vasoactive drugs (60.0% versus 10.5%; p<0.001) and had a longer intensive care unit stay (3.1±2.8 versus 1.4±1.0 days; p=0.014), more clinical complications (60% versus 18.9%; p=0.01), and longer hospital stay (10.2±8.4 versus 5.7±4.9 days; p=0.028).
  
  
  CONCLUSIONS
  Although all patients received the same preoperative preparation, the elderly group exhibited a slower and more complicated recovery after adrenalectomy. Meticulous perioperative care should be used in the elderly when treating phaeochromocytoma; nevertheless, adrenalectomy is a relatively safe procedure in this patient population.
authors: Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Victor
authors: V
authors: Srougi
authors: Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Jose L
authors: JL
authors: Chambo
authors: Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Fabio Y
authors: FY
authors: Tanno
authors: Divisão de Anestesiologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Iracy S
authors: IS
authors: Soares
authors: Divisão de Endocrinologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Madson Q
authors: MQ
authors: Almeida
authors: Divisão de Endocrinologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Maria A A
authors: MA
authors: Pereira
authors: Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Miguel
authors: M
authors: Srougi
authors: Divisão de Endocrinologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.
authors: Maria C
authors: MC
authors: Fragoso
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000592:standards*; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D011183:Postoperative Complications / Q000145:classification; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adrenalectomy; Pheochromocytoma; Surgical Procedures, Operative