Comparison of Perioperative Outcomes Between Laparoscopic and Robot-Assisted Adrenalectomy for Large Pheochromocytoma (≥ 5cm): A Retrospective Study

摘要

Purpose: The objective of this study was to compare perioperative outcomes in patients with large (≥ 5cm) pheochromocytomas who underwent adrenalectomy. Patients and Methods: We retrospectively reviewed patients who underwent laparoscopic adrenalectomy (LA) and robot-assisted adrenalectomy (RA) for large pheochromocytoma (≥ 5cm) at our center between January 2015 to February 2023. We compared the perioperative outcomes between the two groups and investigated impact of high Nor-Metanephrine (NMN) levels on perioperative outcomes by analyzing this subgroup. Results: A total of 115 patients were included in the study, with 48 patients in the robotic group and 67 patients in the laparoscopic group. The following significant difference were identified in favor of RA: shorter operative (excluding docking time) time (190.0 vs 220.0 min, p =0.002), lower estimated blood loss (50.0 vs 120.0 mL, p =0.013), however, RA group has higher surgical expenses (37933.0 vs 7936.0 CNY, p < 0.001). This finding remained consistent when analyzing patients with high NMN levels. Conclusion: Patients with large pheochromocytoma may experience reduced blood loss and shorter operative time when undergoing robot-assisted adrenalectomy. However, it is important to note that the RA approach is associated with significantly higher costs. Keywords: large pheochromocytoma, adrenalectomy, laparoscopic, robotic, high nor-metanephrine