AUTHOR=Ma Lulu , Yu Xuerong , Huang Yuguang 

TITLE=Risk factors for postoperative complications after pheochromocytoma and/or paraganglioma: a single-center retrospective study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1174836

DOI=10.3389/fonc.2023.1174836

ISSN=2234-943X

ABSTRACT=Background:  Perioperative complications are higher in patients with pheochromocytoma and/or paraganglioma. The aim of this study was to identify the risk factors of postoperative complications after pheochromocytoma and/or paraganglioma resection surgery. 
Method: We retrospectively reviewed 438 patients who underwent laparoscopic or open surgery for pheochromocytoma and/or paraganglioma at our center between January 2014 to December 2019. Demographic characteristics, intraoperative and postoperative data were recorded. Complications were defined as deviations from the normal postoperative course and Clavien-Dindo classification was used to grade the severity of postoperative complication. Patients with complications of grade II or above were included for analysis. Binary logistic regression was used to determine the risk factors for postoperative complications. 
Results: The median age of the patients was 47 years old. There were 295 cases (67.4%) of phepchromocytoma and 143 cases (32.6%) of paraganglioma. 367 (87.8%) patients had laparoscopic approach and 55 (12.6%) patients had laparotomy, the conversion rate from laparoscopy to laparotomy was 3.7%. 87 complications occurred in 65 patients (14.8%). No death occurred in our study and transfusion (36, 8.2%) was the most common complication. The mean follow-up length was 14 months. Independent risk factors for postoperative complications included a tumor size larger than 5.6cm (OR 2.427, 95% CI 1.284-4.587, P=0.006), laparotomy(OR 2.590, 95%CI 1.230-5.453, P=0.012),conversion to laparotomy( OR 8.384, 95%CI 2.247-31.285, P=0.002) and the operation time longer than 188 minutes(OR 3.709, 95% CI 1.847-7.450, P<0.001).
Conclusion: Complications were not uncommon after pheochromocytoma and/or paraganglioma surgery. Tumor size, surgical type, operation time were determined as the risk factors for postoperative complications. These factors should be considered to improve perioperative management.