Hypothesis: Pheochromocytoma can be safely treated laparoscopically; "subclinical" pheochromocytoma is increasingly common.
Design: Retrospective review.
Setting: University hospital.
Patients: Patients undergoing adrenalectomy for pheochromocytoma at our institution in 1994 to 2009.
Interventions: Laparoscopic, hand-assisted, and open adrenalectomy.
Main outcome measures: Preoperative and postoperative clinical and biochemical data.
Results: One hundred two patients (52 women, 50 men) with pheochromocytoma underwent 108 operations. Ninety-seven operations were laparoscopic; 7, open; and 4, converted from laparoscopic to hand assisted or open. Six operations were bilateral; 3 were subtotal cortex-sparing resections. Thirty-four patients (33%) presented with adrenal incidentaloma and minimal symptoms, 28 within the past decade. Ten patients had paragangliomas, 7 of whom underwent laparoscopic resection. The mean (SD) tumor size was 5.3 (2.8) cm. Seven patients had recurrence requiring reoperation; the mean length of time between initial operation and recurrence was 6 years (range, 6 months to 17 years). There were no perioperative deaths.
Conclusions: Laparoscopic adrenalectomy can be safely performed for pheochromocytoma in more than 90% of cases. More than one-third of patients presented with subclinical pheochromocytoma. Patients should be followed up closely because recurrence may develop several years after adrenalectomy.