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Perioperative outcomes of laparoscopic, robotic, and open approaches to pheochromocytoma

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Abstract

While multiple studies have demonstrated that minimally invasive surgical (MIS) techniques are a safe and efficacious approach to adrenalectomy for pheochromocytomas (PC), these studies have only been small comparative studies. The aim of this multi-institutional study is to compare perioperative outcomes between open and MIS, stratified by robotic and conventional laparoscopic, techniques in the surgical management of PC. We retrospectively evaluated patients who underwent adrenalectomy for PCs from 2000 to 2017 at three different institutions. Clinical, perioperative, and pathologic parameters were analyzed using t test, Chi square, and Fisher exact statistical measures. Of the 156 adrenalectomy cases performed, 26 (16.7%) were with an open approach and 130 (83.3%) using MIS techniques. Of the MIS procedures, 41 (31.5%) were performed robotically and 89 (68.5%) performed laparoscopically without robotic assistance. Demographic and clinical parameters were similar between the open and MIS groups. Patients, who underwent MIS procedure had a lower complication rate (p = 0.04), shorter hospitalization (p = 0.02), shorter operative time (p < 0.001), and less blood loss (p = 0.002) than those who underwent open surgical resection. Conventional laparoscopic and robotic operative approaches resulted in similar complication rates, length of hospitalization, and blood loss. Our study is one of the largest cohorts comparing the perioperative outcomes between conventional laparoscopic and robotic adrenalectomies in patients with PC. Our results support that MIS techniques have potentially lower morbidity compared to open techniques, while laparoscopic and robotic approaches have similar perioperative outcomes.

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Funding

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Author information

Author notes

  1. Jennifer Gordetsky

    Present address: Department of Pathology, Vanderbilt University, Nashville, TN, USA

  2. Andrew M. Fang and Jennifer Rosen equally contributed to this study.

Authors and Affiliations

  1. Department of Urology, University of Alabama at Birmingham, Faculty Office Tower 1107, 510 20th Street South, Birmingham, AL, 35233, USA

    Andrew M. Fang, Jennifer Rosen, Ava Saidian, Jennifer Gordetsky & Soroush Rais-Bahrami

  2. Division of Preventative Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Sejong Bae

  3. O’Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL, USA

    Sejong Bae & Soroush Rais-Bahrami

  4. Department of Urology, Hospital das Clínicas de São Paulo, University of São Paulo Medical School, São Paulo, Brazil

    Fabio Y. Tanno, Jose L. Chambo & Victor Srougi

  5. Department of Urology, New York Medical College, Valhalla, NY, USA

    Jonathan Bloom & John Phillips

  6. Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA

    Jennifer Gordetsky

  7. Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Soroush Rais-Bahrami

Authors
  1. Andrew M. Fang
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  2. Jennifer Rosen
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  3. Ava Saidian
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  4. Sejong Bae
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  5. Fabio Y. Tanno
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  6. Jose L. Chambo
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  7. Jonathan Bloom
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  8. Jennifer Gordetsky
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  9. Victor Srougi
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  10. John Phillips
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  11. Soroush Rais-Bahrami
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Contributions

AMF: conception and design of the study, acquisition of data, interpretation of the data, drafting the article, final approval. JR: conception and design of the study, acquisition of data, interpretation of the data, drafting the article, final approval. AS: revising, final approval. SB: analysis and interpretation of data, revising, final approval. FYT: acquisition of data, revision, final approval. JLC: acquisition of data, revision, final approval. JB: acquisition of data, revision, final approval. JG: conception and design of the study, revision, final approval. VS: conception and design of the study, revision, final approval. JP: conception and design of the study, revision, final approval. SR-B: conception and design of the study, analysis and interpretation of the data, revision, final approval.

Corresponding author

Correspondence to Soroush Rais-Bahrami.

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Conflict of interest

Soroush Rais-Bahrami, M.D. serves as a consultant for Philips/InVivo Corp, Intuitive Surgical, Genomic Health Inc, Bayer Healthcare, and Blue Earth Diagnostics. AM Fang, J Rosen, A Saidian, S Bae, FY Tanno, JL Chambo, J Bloom, J Gordetsky, V Srougi, and J Phillips declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were approved by the Institutional Review Board of each participating institution and with the 1964 Helsinski Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Fang, A.M., Rosen, J., Saidian, A. et al. Perioperative outcomes of laparoscopic, robotic, and open approaches to pheochromocytoma. J Robotic Surg 14, 849–854 (2020). https://doi.org/10.1007/s11701-020-01056-9

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  • DOI: https://doi.org/10.1007/s11701-020-01056-9

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