D Nel1, E Panieri2, F Malherbe2, R Steyn3, L Cairncross2. 1. Division of General Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. danielnel87@gmail.com. 2. Division of General Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. 3. Division of Nuclear Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
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.
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.
Authors: K Lorenz; P Langer; B Niederle; P Alesina; K Holzer; Ch Nies; Th Musholt; P E Goretzki; N Rayes; M Quinkler; J Waldmann; D Simon; A Trupka; R Ladurner; K Hallfeldt; A Zielke; D Saeger; Th Pöppel; G Kukuk; A Hötker; P Schabram; S Schopf; C Dotzenrath; P Riss; Th Steinmüller; I Kopp; C Vorländer; M K Walz; D K Bartsch Journal: Langenbecks Arch Surg Date: 2019-04-01 Impact factor: 3.445
Authors: Kent W Kercher; Yuri W Novitsky; Adrian Park; Brent D Matthews; Demetrius E M Litwin; B Todd Heniford Journal: Ann Surg Date: 2005-06 Impact factor: 12.969
Authors: Robert Kopetschke; Mario Slisko; Aylin Kilisli; Ulrich Tuschy; Henri Wallaschofski; Martin Fassnacht; Manfred Ventz; Felix Beuschlein; Martin Reincke; Nicole Reisch; Marcus Quinkler Journal: Eur J Endocrinol Date: 2009-06-04 Impact factor: 6.664
Authors: Jacques W M Lenders; Quan-Yang Duh; Graeme Eisenhofer; Anne-Paule Gimenez-Roqueplo; Stefan K G Grebe; Mohammad Hassan Murad; Mitsuhide Naruse; Karel Pacak; William F Young Journal: J Clin Endocrinol Metab Date: 2014-06 Impact factor: 5.958
Authors: Carmen C Solorzano; John I Lew; Scott M Wilhelm; William Sumner; Wendy Huang; William Wu; Raquel Montano; Danny Sleeman; Richard A Prinz Journal: Ann Surg Oncol Date: 2007-08-10 Impact factor: 5.344
Authors: P F Plouin; L Amar; O M Dekkers; M Fassnacht; A P Gimenez-Roqueplo; J W M Lenders; C Lussey-Lepoutre; O Steichen Journal: Eur J Endocrinol Date: 2016-05 Impact factor: 6.664
Authors: Debra M Gordon; Pablo Beckers; Emilie Castermans; Sebastian J C M M Neggers; Liliya Rostomyan; Vincent Bours; Patrick Petrossians; Vinciane Dideberg; Albert Beckers; Adrian F Daly Journal: Endocr Connect Date: 2022-01-31 Impact factor: 3.335