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

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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.

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Correspondence to D. Nel.

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Nel, D., Panieri, E., Malherbe, F. et al. Surgery for Pheochromocytoma: A Single-Center Review of 60 Cases from South Africa. World J Surg (2020). https://doi.org/10.1007/s00268-020-05420-6

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