Division of General Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Division of Nuclear Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
World J Surg. 2020 Jun;44(6):1918-1924. doi: 10.1007/s00268-020-05420-6.
There is a paucity of data on the presentation and surgical management of pheochromocytoma in developing nations, particularly in Africa.
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.
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%).
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.
发展中国家，尤其是非洲，有关嗜铬细胞瘤的临床表现和外科治疗的数据十分有限。
本研究为回顾性研究，纳入了 2002 年 1 月至 2019 年 6 月期间在开普敦大学格罗特舒尔医院/内分泌外科接受治疗的嗜铬细胞瘤和腹部副神经节瘤患者。
研究共纳入 60 例患者，其中 33%为男性，67%为女性。平均年龄为 47 岁（14-81 岁）。肿瘤中位数大小为 6cm，45%的肿瘤大于 6cm。92%的肿瘤位于肾上腺（87%为单侧，5%为双侧），8%为肾上腺外肿瘤。腹腔镜手术的转化率为 20%，总体 55%的病例可通过腹腔镜完成。11 例肿瘤＞6cm 的患者最初尝试腹腔镜手术，其中 3 例转为开放手术，无任何相关的发病率增加。有 5 例（8%）发生了重大不良事件，包括 1 例死亡。总体而言，腹腔镜组的发病率、出血量、手术时间和住院时间均显著降低。有 5 例（8%）患者患有恶性疾病。
这项来自非洲一家成熟的学术内分泌外科的大型系列研究，可以为具有类似设置和资源限制的单位提供基准，以比较他们的手术管理和围手术期结果。
