Long-term follow-up of patients undergoing laparoscopic surgery for phaeochromocytoma

被引:6
作者
O'Dwyer, Patrick J. [1 ]
Chew, Cindy [2 ]
Zino, Samer [3 ]
Serpell, Michael G. [4 ]
机构
[1] Univ Glasgow, Sch Med Dent & Med, Glasgow, Lanark, Scotland
[2] Univ Hosp Hairmyres, Dept Radiol, Glasgow, Lanark, Scotland
[3] Ninewells Hosp, Dept Surg, Dundee, Scotland
[4] Univ Glasgow, Dept Anaesthesia, Glasgow, Lanark, Scotland
关键词
ADRENALECTOMY; RESECTION; BENIGN;
D O I
10.1093/bjsopen/zrac076
中图分类号
R61 [外科手术学];
学科分类号
摘要
Long-term follow-up studies for phaeochromocytoma are lacking. This study demonstrates that the long-term oncological outcomes for laparoscopic surgery are at least equivalent to open operation for phaeochromocytoma. Introduction Phaeochromocytomas are rare tumours with a recurrence after open surgery ranging between 6-23 per cent. Long-term follow-up studies after laparoscopic surgery for phaeochromocytoma are lacking. The aim of this study was to look at the long-term oncological outcome of a consecutive series of patients from a single centre undergoing laparoscopic surgery for a phaeochromocytoma. Methods Demographic data on all patients with an adrenal tumour or paraganglioma were prospectively kept on a database between September 1999 and December 2017. Electronic hospital records, including imaging from a national linked archiving and communication system, were reviewed for patients with a phaeochromocytoma in November 2021. Results During the study interval 135 patients with a phaeochromocytoma were operated on in the unit, of which 118 (87.4 per cent) were attempted laparoscopically. Five (4.2 per cent) were converted to open surgery, whereas 117 had a potentially curative operation. There was no peri- or postoperative mortality. At a median follow-up of 10 (interquartile range 6-12.9) years, only 3 (2.6 per cent) patients died from metastatic phaeochromocytoma. One further patient developed lymph node metastases, which were removed at open surgery. No patient had a local recurrence and the only significant predictor of recurrence was the presence of lymph node metastases (P < 0.001). Two patients developed a contralateral adrenal phaeochromocytoma, while one of these also had a paraganglioma. The Kaplan-Meier estimate of phaeochromocytoma-free survival was 96 per cent (95 per cent c.i. 92.2 to 98.8) at 5 years and 92 per cent (95 per cent c.i. 86.7 to 97.3) at 10 years. Conclusion This study demonstrates that long-term oncological outcomes of laparoscopic surgery for patients with a phaeochromocytoma are at least as good as that with an open operation.
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