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Background <p>Long-term single center series remain useful for describing perioperative outcomes after laparoscopic adrenalectomy for Pheochromocytoma (PCC), particularly the clinical impact of intraoperative hemodynamic instability.</p> Methods <p>We retrospectively reviewed all eligible consecutive patients who underwent laparoscopic adrenalectomy for histologically confirmed adrenal pheochromocytoma between January 2003 and December 2024. Patients with non-PCC adrenal disease, extra-adrenal paraganglioma, or lesions requiring upfront surgery for suspected invasion were excluded. Outcomes were analyzed descriptively.</p> Results <p>Among 304 laparoscopic adrenalectomies, 64 patients (21.1%) had adrenal PCC. Mean age was 49.5 years (range, 20–79), 40 patients (62.5%) were female, and mean tumor size was 5.44&#xa0;cm (range, 3.2–8.2). Conversion occurred in one patient (1.6%). Mean operative time was 100&#xa0;min, mean blood loss was 120 mL, and no transfusions or 30-day deaths occurred. Thirty-day morbidity was 9.3%, with one Grade IIIa event and no Grade IV/V events. Hypertensive episodes, defined as systolic blood pressure &gt; 180 mmHg, were recorded in 48 patients (75.0%) under continuous arterial monitoring. Hormonal normalization was achieved in 62 patients (96.8%) and blood pressure normalization in 58 (90.6%). During mean follow-up of 46.4 months (range, 4-150), one case of persistent disease and one local recurrence were observed; no distant metastasis or disease-specific death was observed.</p> Conclusion <p>In selected adrenal PCCs, laparoscopic adrenalectomy was associated with low conversion, low morbidity, and high biochemical cure. The high rate of hypertensive episodes reflects the strict threshold used and does not support causal inference regarding morbidity.</p>

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Laparoscopic Adrenalectomy for Pheochromocytoma: Twenty-Year Institutional Experience in 64 Consecutive Patients from a Tertiary Center

  • 期刊论文

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  • 发表日期：

    2026年6月30日

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  • Federico Maria Mongardini,
  • Giuseppe Bellastella,
  • Alessandra Conzo,
  • Luigi Flagiello,
  • Gloria Marchesiello,
  • Francesca Allosso,
  • Lucia Digitale Selvaggio,
  • Antonio Agostino Sinisi,
  • Daniela Pasquali,
  • Luigi Marano,
  • Yogesh Vashist,
  • Ludovico Docimo,
  • Giovanni Conzo

摘要

Background

Long-term single center series remain useful for describing perioperative outcomes after laparoscopic adrenalectomy for Pheochromocytoma (PCC), particularly the clinical impact of intraoperative hemodynamic instability.

Methods

We retrospectively reviewed all eligible consecutive patients who underwent laparoscopic adrenalectomy for histologically confirmed adrenal pheochromocytoma between January 2003 and December 2024. Patients with non-PCC adrenal disease, extra-adrenal paraganglioma, or lesions requiring upfront surgery for suspected invasion were excluded. Outcomes were analyzed descriptively.

Results

Among 304 laparoscopic adrenalectomies, 64 patients (21.1%) had adrenal PCC. Mean age was 49.5 years (range, 20–79), 40 patients (62.5%) were female, and mean tumor size was 5.44 cm (range, 3.2–8.2). Conversion occurred in one patient (1.6%). Mean operative time was 100 min, mean blood loss was 120 mL, and no transfusions or 30-day deaths occurred. Thirty-day morbidity was 9.3%, with one Grade IIIa event and no Grade IV/V events. Hypertensive episodes, defined as systolic blood pressure > 180 mmHg, were recorded in 48 patients (75.0%) under continuous arterial monitoring. Hormonal normalization was achieved in 62 patients (96.8%) and blood pressure normalization in 58 (90.6%). During mean follow-up of 46.4 months (range, 4-150), one case of persistent disease and one local recurrence were observed; no distant metastasis or disease-specific death was observed.

Conclusion

In selected adrenal PCCs, laparoscopic adrenalectomy was associated with low conversion, low morbidity, and high biochemical cure. The high rate of hypertensive episodes reflects the strict threshold used and does not support causal inference regarding morbidity.