SFEBES2009 Poster Presentations Endocrine tumours and neoplasia (39 abstracts)
Open or laparoscopic surgery for phaeochromocytoma
Tarek Ezzat 1 , James Skipworth 1 , Dimitris Raptis 1 , Gerard Conway 1 , Stefie Baldweg 1 , Jamshed Bomanji 1 , Pierre Bouloux 2 , Keith Rolles 2 , Bernard Khoo 2 , Penny Hyatt 3 , Michaela Rossi 4 , Maria Barnard 4 , Karen Anthony 4 , Nemanja Stojanovic 5 , Mark Cohen 5 , Jonathan Katz 5 , Christopher Baynes 5 , Sabina Russel 5 , James Ahlquist 6 & Tom Kurzawinski 1
1University College London Hospital, London, UK; 2Royal Free Hospital, London, UK; 3North Middlesex, London, UK; 4Whittington Hospital, London, UK; 5Chase Farm/Barnet Hospital, London, UK; 6Southend Hospital, London, UK.
Background: Surgical resection is the treatment of choice for phaeochromocytomas. Introduction of laparoscopic adrenalectomy (LA) led to a reduction in the number of open adrenalectomies (OA); however, there is limited information comparing the two techniques.
Objectives: We report here a comparison of LA and OA operations for phaeochromocytoma performed over 20 years.
Methods: We performed a retrospective review of all patients undergoing surgery for phaeochromocytoma in a single centre. Data collected included demographics, clinical presentation, type of surgery, lengths of hospital stay and operation, size and site of tumour, conversion rate, morbidity and mortality.
Results: Between September 1988 and October 2009, 44 patients (20M: 24F, mean age=45.49 years) with phaeochromocytoma (n=40) and paraganglioma (n=4) presented with classical symptoms (14), hypertension only (15), in pregnancy (3), hypertensive crisis (2), incidentalomas (5) and 5 from screening patients with endocrine syndromes. Twenty-two tumours were right-sided, 22 were left-sided.
Nineteen patients had OA (12 before beginning the laparoscopic program, three tumours > 10 cm, four paragangliomas) and 25 LA. Median tumour size was 4.8 cm (1.3–8) in the LA group and 7 cm (2.4–15) in the OA group (P=0.039). The median operative time was 130 min (78–264) in the LA group and 152 min (98–260) for the OA group (P=0.088). Median hospital stay was 4 days (2–12 days) for the LA group and 13 days (6–36 days) for the OA group (P=0.001). Two LAs were converted to OA. All postoperative complications (wound infection 3, PE 1) occurred in OA group. There was no mortality.
Conclusion: In our series, LA took no longer than OA and was associated with fewer postoperative complications and shorter hospital stay. LA is a procedure of choice for most phaeochromocytomas and OA should be reserved for tumours >10 cm and paragangliomas.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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