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


中文翻译：

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腹腔镜与机器人辅助肾上腺切除术治疗大型嗜铬细胞瘤（≥ 5cm）围手术期结果的比较：一项回顾性研究

目的：本研究的目的是比较接受肾上腺切除术的大型（≥ 5cm）嗜铬细胞瘤患者的围手术期结局。
患者和方法：我们回顾性分析了 2015 年 1 月至 2023 年 2 月期间在我中心因大型嗜铬细胞瘤（≥ 5cm）接受腹腔镜肾上腺切除术（LA）和机器人辅助肾上腺切除术（RA）的患者。我们比较了两组的围手术期结果，通过分析该亚组，研究了高去甲变肾上腺素 (NMN) 水平对围手术期结果的影响。
结果：本研究共纳入115例患者，其中机器人组48例，腹腔镜组67例。以下显着差异有利于 RA：手术时间（不包括对接时间）更短（190.0 vs 220.0 分钟，p = 0.002），估计失血量较低（50.0 vs 120.0 mL，p = 0.013），然而，RA 组手术费用较高（37933.0 元 vs 7936.0 元人民币，p < 0.001）。在分析 NMN 水平高的患者时，这一发现仍然一致。
结论：大型嗜铬细胞瘤患者接受机器人辅助肾上腺切除术可能会减少失血量并缩短手术时间。然而，值得注意的是，RA 方法的成本明显较高。

关键词：大型嗜铬细胞瘤，肾上腺切除术，腹腔镜，机器人，高去甲变肾上腺素