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. 2023 Aug;46(8):1589-1596.
doi: 10.1007/s40618-023-02013-7. Epub 2023 Jan 27.

Is transperitoneal laparoscopic adrenalectomy for pheochromocytoma really more challenging? A propensity score-matched analysis

D Corallino  1 , A Balla  2 , L Palmieri  3 , I Sperduti  4 , M Ortenzi  5 , M Guerrieri  5 , A M Paganini  3
Affiliations

Is transperitoneal laparoscopic adrenalectomy for pheochromocytoma really more challenging? A propensity score-matched analysis

D Corallino et al. J Endocrinol Invest. 2023 Aug.

Abstract

Purpose: Minimally invasive surgery is the gold standard treatment for adrenal masses, but it may be a challenging procedure in the case of pheochromocytoma (PHEO). The aim of the present study is to report the results of transperitoneal laparoscopic adrenalectomy (TLA) in cases of PHEO in comparison to other types of adrenal lesions.

Methods: From 1994 to 2021, 629 patients underwent adrenalectomy. Twenty-two and thirty-five patients, respectively, were excluded because they underwent bilateral and open adrenalectomy, leaving 572 patients for inclusion. Of these, 114 patients had PHEO (Group A), and 458 had other types of lesions (Group B). To adjust for potential baseline confounders, a propensity score matching (PSM) analysis was conducted.

Results: After PSM, 114 matched pairs of patients were identified from each group. Statistically significant differences were not observed when comparing the median operative time (85 and 90 min in Groups A and B, respectively, p = 0.627), conversion rate [6 (5.3%) in each group, p = 1.000], transfusion rate [4 (3.5%) and 3 (2.6%) in Groups A and B, respectively, p = 1.000], complication rate [7 (6.1%) and 9 (7.9%) in Groups A and B, respectively, p = 0.796), median postoperative hospital stay (3.9 and 3.6 days in Groups A and B, respectively, p = 0.110), and mortality rate [1 (0.9%) in each group, p = 1.000].

Conclusions: Based on this analysis, the results of TLA for PHEO are equivalent to those of TLA for other types of adrenal lesions, but the fundamental requirements are multidisciplinary patient management and adequate surgeon experience. Further prospective studies are required to draw definitive conclusions.

Keywords: Adrenal lesions; Open adrenalectomy (OA); Pheochromocytoma (PHEO); Propensity score matching (PSM); Transperitoneal laparoscopic adrenalectomy (TLA).

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Conflict of interest statement

Diletta Corallino, Andrea Balla, Livia Palmieri, Isabella Sperduti, Monica Ortenzi, Mario Guerrieri and Alessandro M. Paganini declare that they have no conflict of interest or financial ties to disclose.

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