SRS374 - Postoperative outcomes following laparoscopic adrenalectomy for phaeochromocytoma and paraganglioma: A 13-year retrospective analysis

Abstract Background Phaeochromocytomas and paragangliomas are rare catecholamine-secreting neuroendocrine tumors that present major perioperative challenges due to the risk of severe cardiovascular instability. Laparoscopic adrenalectomy has become the preferred surgical approach, however, these procedures remain high risk. Evaluating postoperative outcomes, including complication rates and length of hospital stay (LOS), is essential to optimize perioperative management and patient care. Methods A retrospective analysis was performed on patients who underwent laparoscopic adrenalectomy for phaeochromocytoma and/or paraganglioma between 2009 and 2022. Pre- and postoperative data were collected, including α-blocker and β-blocker administration, 24-hour urine metanephrine levels, chromogranin A (CgA) levels, operative details, and follow-up outcomes. Results Forty-eight patients were included, with a mean age of 43 years. Preoperative α-blockade was administered in 47 patients, while 35 received β-blockers. Elevated urine metanephrines were found in 47 patients, and elevated CgA levels in 44. The mean LOS was 4 days. Based on Clavien–Dindo classification, 34 patients (71%) had no complications, 11 (23%) had Grade I, one (2%) had Grade II, and one (2%) had Grade IV. Conversion to open surgery occurred in 2% of cases. Resection margins were R0 in 44 patients and R1 in 4. The mean operative time was 4.2 h, with minimal blood loss in most cases. Conclusions Laparoscopic adrenalectomy for phaeochromocytoma and paraganglioma is associated with a relatively short hospital stay and a low incidence of significant complications in high-volume Centres. Careful preoperative preparation and vigilant postoperative monitoring are essential to optimize outcomes in this high-risk group.