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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2013

01-02-2013

Outcomes of resection of extra-adrenal pheochromocytomas/paragangliomas in the laparoscopic era: a comparison with adrenal pheochromocytoma

Authors: Trudie A. Goers, Michael Abdo, Jeffrey F. Moley, Brent D. Matthews, Mary Quasebarth, L. Michael Brunt

Published in: Surgical Endoscopy | Issue 2/2013

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Abstract

Introduction

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.
Literature
1.
Janetschek G, Finkenstedt G, Gasser R et al (1998) Laparoscopic surgery for pheochromocytoma: adrenalectomy, partial resection, excision of paragangliomas. J Urol 160:330–334PubMedCrossRef
2.
Brunt LM, Moley JM, M DG, Lairmore TC, DeBenedetti MK, Quasebarth MA (2001) Outcomes analysis in patients undergoing laparoscopic adrenalectomy for hormonally active adrenal tumors. Surgery 130:629–635
3.
Cheah WK, Clark OH, Horn JK, Siperstein AE, Duh Q-Y (2002) Laparoscopic adrenalectomy for pheochromocytoma. World J Surg 26:1048–1051PubMedCrossRef
4.
Kercher KW, Park A, Matthews BD, Rolband G, Sing RF, Heniford BT (2002) Laparoscopic adrenalectomy for pheochromocytoma. Surg Endosc 16:100–102PubMedCrossRef
5.
Grant CS (2005) Pheochromocytoma. In: Clark OH, Duh Q-Y, Kebebew E (eds) Textbook of endocrine surgery. Elsevier Saunders, Philadelphia, pp 621–633CrossRef
6.
O’Riordain DS, Young WF, Grant CS, Carney JA, van Heerden JA (1996) Clinical spectrum and outcome of functional paraganglioma. World J Surg 20:916–922PubMedCrossRef
7.
Suh I, Shibru D, Eisenhofer G (2009) Candidate genes associated with malignant pheochromocytomas by genome-wide expression profiling. Ann Surg 250:983–990PubMedCrossRef
8.
Castillo OA, Vitiagliano G, Olivares R, Soffa PC, Contreras M (2007) Laparoscopic resection of an extra-adrenal pheochromocytoma. Surg Laparosc Percutaneous Endosc Tech 17:351–353CrossRef
9.
Zervos EE, Durkin AJ, Villadolid D, Vohra N (2008) Laparoscopic resection of extraadrenal pheochromocytoma. Ann Surg Oncol 15:499PubMedCrossRef
10.
Kelliher K, Santiago A, Estrada E, Campbell BT (2009) Laparoscopic excision of a familial paraganglioma. J Laparoendosc Adv Surg Tech 19(S1):S155–S158CrossRef
11.
Nozaki T, Iida H, Tsuritani S, Okumura A, Komiya A, Fuse H (2010) Laparoscopic resection of retrocaval paraganglioma. J Laparoendosc Adv Surg Tech 20:363–367CrossRef
12.
13.
Clavien P-A, Sanabria JR, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518–526PubMed
14.
Lee KY, Oh Y-W, Noh HJ et al (2006) Extra-adrenal paragangliomas of the body: imaging features. AJR Am J Roentgenol 187:492–504PubMedCrossRef
15.
Timmers H, Chen C, Carrasquillo J et al (2009) Comparison of 18F-fluoro-L-DOPA, and 18F-fluorodopamine PET and 123I-MIBG scintigraphy in the localization of pheochromocytoma and paraganglioma. J Clin Endocrinol Metab 94:4757–4767PubMedCrossRef
16.
Tagaya N, Suzuki N, Furihata T, Kubota K (2002) Laparoscopic resection of a functional paraganglioma in the organ of Zuckerkandl. Surg Endosc 16:219PubMed
17.
Shen W, Grogan R, Vriens M, Clark O, Duh Q-Y (2010) One hundred two patients with pheochromocytoma at a single institution since the introduction of laparoscopic adrenalectomy. Arch Surg 145:893–897PubMedCrossRef
18.
Walz M, Alesin P, Wenger F et al (2006) Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas: results of 161 tumors in 126 patients. World J Surg 30:899–908PubMedCrossRef
19.
Quayle FJ, Spitler JA, Pierce RA, Lairmore TL, Moley JF, LM B (2007) Needle biopsy of incidentally discovered adrenal masses is rarely informative and potentially hazardous. Surgery 142:497–504
20.
van Heerden JA, Roalnd CF, Carney JA, Sheps SG, Grant CS (1990) Long-term evaluation following resection of apparently benign pheochromocytoma(s)/paraganglioma(s). World J Surg 14:325–329PubMedCrossRef
21.
Slycke S, Caiazzo R, Pigny P et al (2009) Local-regional recurrence of sporadic or syndromic abdominal extra-adrenal paragangliomas: incidence, characteristics, and outcome. Surgery 146:986–992PubMedCrossRef
22.
Tessier DJ, Iglesias R, Chapman WC et al (2009) Previously unreported high-grade complications of adrenalectomy. Surg Endosc 23:97–102PubMedCrossRef
Metadata
Title
Outcomes of resection of extra-adrenal pheochromocytomas/paragangliomas in the laparoscopic era: a comparison with adrenal pheochromocytoma
Authors
Trudie A. Goers
Michael Abdo
Jeffrey F. Moley
Brent D. Matthews
Mary Quasebarth
L. Michael Brunt
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 2/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2451-9

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