{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:29:22Z","timestamp":1786649362075,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Pheochromocytoma (PHEO) arises from the chromophil cells of the adrenal medulla. Surgical resection is the primary treatment for PHEO. Our work aimed to investigate the efficacy and safety of minimally invasive surgery in patients with large PHEO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This study included patients who were referred to our centre, General Surgery Outpatient Clinic, between January 2007 and December 2023, who were interviewed by a multidisciplinary endocrine board, who were diagnosed with PHEO by clinical and laboratory examination and who decided to undergo unilateral laparoscopic adrenalectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 275 patients had laparoscopic unilateral adrenalectomy during the research period. A total of 75 patients were operated on for PHEO. The PHEO group with a tumour size &lt;6 cm consists of 46 patients, while the PHEO group with a tumour size &gt;6 cm consists of 29 patients. The groups showed similar complications, conversion rates and hospital stays. We used multiple regression analysis to identify the independent predictors of prolonged operation time. The tumour size 6\u20138 cm (odds ratio [OR], 3.214; 95% confidence interval [CI], 1.240\u201310.819;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.021) and the tumour size \u22658 cm (OR, 6.343; 95% CI, 1.175\u201334.237;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.031) were the significant predictors of prolonged operation time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Minimally invasive surgery can be considered the treatment of choice for &lt;6 cm and \u22656 cm PHEO. Tumour size \u22658 cm and tumour size \u22656\u20138 cm for PHEO are predictive risk factors for prolonged operative time in LA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_82_24","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T14:01:39Z","timestamp":1775743299000},"page":"120-127","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Minimally invasive adrenalectomy for the treatment of large pheochromocytoma: A single-centre experience"],"prefix":"10.4103","volume":"22","author":[{"given":"Sedat","family":"\u00c7ark\u0131t","sequence":"first","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahad\u0131r","family":"\u00d6z","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Karaa\u011fa\u00e7","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"G\u00f6k","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Akcan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"R1-20260410","doi-asserted-by":"crossref","first-page":"3865","DOI":"10.1245\/s10434-014-3847-7","article-title":"Predictors of hemodynamic instability during surgery for pheochromocytoma","volume":"21","author":"Kiernan","year":"2014","journal-title":"Ann Surg Oncol"},{"key":"R2-20260410","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1210\/jc.2014-1498","article-title":"Pheochromocytoma and paraganglioma:An endocrine society clinical practice guideline","volume":"99","author":"Lenders","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"R3-20260410","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/cen.13544","article-title":"Preoperative risk factors for haemodynamic instability during pheochromocytoma surgery in Chinese patients","volume":"88","author":"Jiang","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R4-20260410","first-page":"417","article-title":"Laparoscopic treatment of pheochromocytomas smaller or larger than 6 cm. A clinical retrospective study on 44 patients. Laparoscopic adrenalectomy for pheochromocytoma","volume":"84","author":"Conzo","year":"2013","journal-title":"Ann Ital Chir"},{"key":"R5-20260410","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ijsu.2012.12.007","article-title":"Laparoscopic adrenalectomy, a safe procedure for pheochromocytoma. A retrospective review of clinical series","volume":"11","author":"Conzo","year":"2013","journal-title":"Int J Surg"},{"key":"R6-20260410","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1089\/089277902753752223","article-title":"Laparoscopic adrenalectomy for pheochromocytoma:Morbidity compared with adrenalectomy for tumors of other pathology","volume":"16","author":"Gotoh","year":"2002","journal-title":"J Endourol"},{"key":"R7-20260410","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/bju.13707","article-title":"Laparoscopic adrenalectomy:The 'gold standard'when performed appropriately","volume":"119","author":"Matsuda","year":"2017","journal-title":"BJU Int"},{"key":"R8-20260410","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1007\/s00464-009-0801-z","article-title":"Laparoscopic adrenalectomy for large unilateral pheochromocytoma:Experience in a large academic medical center","volume":"24","author":"Perry","year":"2010","journal-title":"Surg Endosc"},{"key":"R9-20260410","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1111\/j.1464-410X.2007.07179.x","article-title":"Laparoscopic adrenalectomy for large pheochromocytoma","volume":"100","author":"Indupur","year":"2007","journal-title":"BJU Int"},{"key":"R10-20260410","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications:A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"R11-20260410","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/S1015-9584(09)60202-5","article-title":"Comparison of laparoscopic and open adrenalectomy \u2013A Singapore experience","volume":"25","author":"Tan","year":"2002","journal-title":"Asian J Surg"},{"key":"R12-20260410","first-page":"203","article-title":"Comparison of laparoscopic and open adrenalectomy","volume":"113","author":"Bulus","year":"2013","journal-title":"Acta Chir Belg"},{"key":"R13-20260410","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1007\/s002689910094","article-title":"Comparison of the hemodynamic parameters of open and laparoscopic adrenalectomy for pheochromocytoma","volume":"24","author":"Inabnet","year":"2000","journal-title":"World J Surg"},{"key":"R14-20260410","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.asjsur.2015.04.009","article-title":"Laparoscopic surgery in functional and nonfunctional adrenal tumors:A single-center experience","volume":"39","author":"\u00d6z","year":"2016","journal-title":"Asian J Surg"},{"key":"R15-20260410","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1007\/s00268-002-6669-x","article-title":"Laparoscopic adrenalectomy for pheochromocytoma","volume":"26","author":"Cheah","year":"2002","journal-title":"World J Surg"},{"key":"R16-20260410","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/S0039-6060(96)80020-1","article-title":"Adrenalectomy in the era of laparoscopy","volume":"120","author":"Staren","year":"1996","journal-title":"Surgery"},{"key":"R17-20260410","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ijsu.2018.11.018","article-title":"Comparison of transperitoneal laparoscopic versus open adrenalectomy for large pheochromocytoma:A retrospective propensity score-matched cohort study","volume":"61","author":"Bai","year":"2019","journal-title":"Int J Surg"},{"key":"R18-20260410","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.amjsurg.2014.11.012","article-title":"Effectiveness and safety of laparoscopic adrenalectomy of large pheochromocytoma:A prospective, nonrandomized, controlled study","volume":"210","author":"Wang","year":"2015","journal-title":"Am J Surg"},{"key":"R19-20260410","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00423-021-02312-8","article-title":"Minimally invasive adrenalectomy for large pheochromocytoma:Not recommendable yet?Results from a single institution case series","volume":"407","author":"Arolfo","year":"2022","journal-title":"Langenbecks Arch Surg"},{"key":"R20-20260410","doi-asserted-by":"crossref","first-page":"3845","DOI":"10.1007\/s00464-011-1804-0","article-title":"Complications in laparoscopic adrenalectomy:The value of experience","volume":"25","author":"Bergamini","year":"2011","journal-title":"Surg Endosc"},{"key":"R21-20260410","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1089\/end.2006.450","article-title":"Predictive factors for open conversion of laparoscopic adrenalectomy:A 13-year review of 456 cases","volume":"21","author":"Shen","year":"2007","journal-title":"J Endourol"},{"key":"R22-20260410","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4103\/jmas.jmas_217_22","article-title":"Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater:A single-centre experience","volume":"20","author":"\u00d6z","year":"2024","journal-title":"J Minim Access Surg"},{"key":"R23-20260410","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/j.urology.2013.05.063","article-title":"Visceral fat is correlated with prolonged operative time in laparoendoscopic single-site adrenalectomy and laparoscopic adrenalectomy","volume":"82","author":"Hasegawa","year":"2013","journal-title":"Urology"},{"key":"R24-20260410","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1002\/bjs.4738","article-title":"Laparoscopic adrenalectomy","volume":"91","author":"Assalia","year":"2004","journal-title":"Br J Surg"},{"key":"R25-20260410","doi-asserted-by":"crossref","first-page":"1043753","DOI":"10.3389\/fonc.2023.1043753","article-title":"Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (\u22656cm) pheochromocytomas:A single-centre retrospective study","volume":"13","author":"Lei","year":"2023","journal-title":"Front Oncol"},{"key":"R26-20260410","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1097\/JS9.0000000000000389","article-title":"The role of laparoscopic adrenalectomy in the treatment of large pheochromocytomas (>6 cm):A meta-analysis and systematic review","volume":"109","author":"Gan","year":"2023","journal-title":"Int J Surg"},{"key":"R27-20260410","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1186\/s12957-023-03164-w","article-title":"Which surgical approach is more favorable for pheochromocytoma of different sizes (< 6 cm versus \u2265 6 cm)?A single retrospective center experience","volume":"21","author":"Wan","year":"2023","journal-title":"World J Surg Oncol"},{"key":"R28-20260410","doi-asserted-by":"crossref","first-page":"780","DOI":"10.21037\/tau.2016.08.10","article-title":"Laparoscopic adrenalectomy for pheochromocytoma-does size matter?A single surgeon comparative study","volume":"5","author":"Rao","year":"2016","journal-title":"Transl Androl Urol"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_82_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:53:08Z","timestamp":1786647188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_82_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_82_24","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2024-04-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}