Effectiveness and safety of laparoscopic adrenalectomy of large pheochromocytoma: a prospective, nonrandomized, controlled study

• LA had a longer operative time for treating large-sized pheochromocytoma.
• LA was superior in minimal invasiveness and faster postoperative recovery.
• LA had a risk of tumor recurrence similar to open procedure.

BackgroundLaparoscopic adrenalectomy (LA) is normally used to treat small-sized (<6 cm) pheochromocytoma (PCC). This study evaluated the effectiveness and safety of LA for treating large (≥6 cm) PCC.MethodsFifty-one patients with resectable, large-sized (≥6 cm) PCC were prospectively enrolled for elective LA (n = 23) or open adrenalectomy (n = 28).ResultsLA was converted into open adrenalectomy in 2 patients (2/23, 8.7%); LA was associated with relatively longer operative time (P = .033) but less intraoperative bleeding (P < .001), faster resumption of ambulatory status (P < .001), and shorter duration of postoperative hospitalization (P < .001). Frequency of PCC recurrence was similar between the 2 groups (P = 1.000).ConclusionsLA is a feasible, effective, and safe treatment modality for large-sized (≥6 cm) PCC. LA is associated with minimal invasiveness and faster postoperative recovery.