Surgery for Pheochromocytoma: A Single-Center Review of 60 Cases from South Africa

World J Surg. 2020 Jun;44(6):1918-1924. doi: 10.1007/s00268-020-05420-6.

Abstract

Background: There is a paucity of data on the presentation and surgical management of pheochromocytoma in developing nations, particularly in Africa.

Methods: This study was a retrospective review, which included all patients managed by the Groote Schuur Hospital/University of Cape Town Endocrine Surgery unit for pheochromocytoma and abdominal paragangliomas, from January 2002 to June 2019.

Results: Sixty patients were included in the study, of which 33% were male and 67% female. The mean age was 47 years (range 14-81). The median tumor size was 6 cm, with 45% larger than 6 cm. 92% were located in the adrenal gland (87% unilateral, 5% bilateral), and 8% were extra-adrenal. The conversion rate for laparoscopic cases was 20%, with 55% of cases overall completed laparoscopically. Eleven patients with tumors > 6 cm were initially attempted laparoscopically, of which 3 were converted to open, without any associated increased morbidity. A major adverse event was recorded for 5 cases (8%), including 1 mortality. Overall morbidity, blood loss, operating time and hospital stay were all significantly reduced in the laparoscopic group. There were 5 patients with malignant disease (8%).

Conclusion: This large series, from an established academic endocrine surgery unit in Africa, can serve as a benchmark for units with similar settings and resource limitations, to compare their surgical management and perioperative outcomes.

MeSH terms

  • Adolescent
  • Adrenal Gland Neoplasms / pathology
  • Adrenal Gland Neoplasms / surgery*
  • Adrenal Glands / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Laparoscopy
  • Length of Stay
  • Male
  • Middle Aged
  • Pheochromocytoma / pathology
  • Pheochromocytoma / surgery*
  • Retrospective Studies
  • Young Adult