Minimally invasive adrenalectomy for the treatment of large pheochromocytoma: A single-centre experience

INTRODUCTION: Pheochromocytoma (PHEO) arises from the chromophil cells of the adrenal medulla. Surgical resection is the primary treatment for PHEO. Our work aimed to investigate the efficacy and safety of minimally invasive surgery in patients with large PHEO. PATIENTS AND METHODS: This study included patients who were referred to our centre, General Surgery Outpatient Clinic, between January 2007 and December 2023, who were interviewed by a multidisciplinary endocrine board, who were diagnosed with PHEO by clinical and laboratory examination and who decided to undergo unilateral laparoscopic adrenalectomy. RESULTS: A total of 275 patients had laparoscopic unilateral adrenalectomy during the research period. A total of 75 patients were operated on for PHEO. The PHEO group with a tumour size <6 cm consists of 46 patients, while the PHEO group with a tumour size >6 cm consists of 29 patients. The groups showed similar complications, conversion rates and hospital stays. We used multiple regression analysis to identify the independent predictors of prolonged operation time. The tumour size 6-8 cm (odds ratio [OR], 3.214; 95% confidence interval [CI], 1.240-10.819; P < 0.021) and the tumour size ≥8 cm (OR, 6.343; 95% CI, 1.175-34.237; P < 0.031) were the significant predictors of prolonged operation time. CONCLUSION: Minimally invasive surgery can be considered the treatment of choice for <6 cm and ≥6 cm PHEO. Tumour size ≥8 cm and tumour size ≥6-8 cm for PHEO are predictive risk factors for prolonged operative time in LA.