Is Laparoscopic Adrenalectomy for Pheochromocytoma a Safe and Effective
Surgery in Geriatric Patients?
Abstract
Objectives: In this study, we aimed to evaluate the haemodynamic changes
of laparoscopic adrenalectomy (LA) in geriatric patients with
pheochromocytoma (PHEO). To the best of our knowledge, it is the first
study evaluating the haemodynamic outcomes of pure LA in this patient
population. Methods: Between 2000-2020, data of 350 patients who
underwent single-side transperitoneal LA were reviewed retrospectively.
Patients with a histopathological diagnosis of PHEO were enrolled and
classified into two groups according to their ages at the date of
surgery. Older than 65 years were accepted as elderly according to the
World Health Organisation recommendations. Results: Overall 54 patients
underwent single side LA for PHEO. Fifteen patients were enrolled in the
elderly group and 39 in the young group. There were no significant
differences regarding the operation site (0.564) and tumour size
(0.878). There were no statistically significant differences in terms of
perioperative outcomes, such as mean anaesthesia and operation times,
blood loss and haemodynamic changes. Regarding postoperative outcomes;
there were no statistically significant differences in mean
hospitalization and intensive care unit times. In 1 patient in each
grade-1 (prolonged ileus, managed with medical treatment) and grade 2
complication (transfusion during surgery) observed in the elderly and
young groups, respectively (p=0.498). Conclusion: Laparoscopic
adrenalectomy in elderly patients with PHEO is as safe and effective as
in younger patients. One of the most important conditions for achieving
good perioperative and postoperative outcomes in the elderly patient
population with this challenging surgery is the multidisciplinary
approach.