Safety of Synchronous Laparoscopic Resection of Bilateral Pheochromocytomas/Paragangliomas: A Single-Center Retrospective Study

Background Synchronous resection of bilateral pheochromocytomas/paragangliomas (PPGLs) might increase risk of blood loss, hemodynamic instability, and postoperative complications. However, owing to the low incidence of bilateral PPGLs, evidence of safety for these surgeries is not enough, with only case reports available. This study reported a series of bilateral PPGLs case. All the patients received synchronous laparoscopic resection of tumors. Methods Patients underwent synchronous laparoscopic resection of bilateral pheochromocytoma were included. Clinical data including preoperative variables, intraoperative blood loss and transfusion, and postoperative recovery were collected. Results A total of 23 patients were collected. Median intraoperative blood loss was 200 ml (IQR 50, 350), with blood loss/estimated blood volume (EBV) ratio of 3.2%. No allogeneic transfusion required intraoperatively, and the postoperative allogeneic transfusion rate was 4.3%. 82.6% (19/23), 30.4% (7/23), and 17.4% (4/23) of patients required low-dose norepinephrine support at the end of operation, during ICU observation, and at 24 hours respectively. The incidence of postoperative mechanical ventilation duration > 24 h and Foley catheterization duration > 4 days was 17.4% and 13% respectively. ICU and hospital stay duration was 1 day (IQR 1, 1) and 7 days (IQR 4, 7) respectively. Postoperative complication rate was 17.4%. No postoperative mortality and 30-day occured. Conclusion Compared with unilateral tumor resection, we did not find synchronous resection of bilateral PPGLs with more risks of hemorrhage-related complications, hemodynamic fluctuations, or prolonged postoperative recovery.