Citation Information :
Park B, Xia W, Karalus M, Moss D, Rahman H, Biggar M. Adrenalectomy and Abdominal Paraganglioma Surgery at an Ethnically Diverse New Zealand Center: Māori Ethnicity Frequent amongst Paraganglioma Patients. World J Endoc Surg 2022; 14 (3):73-78.
Aim: To identify the indications for adrenal and abdominal paraganglioma operations by ethnicity in an ethnically diverse New Zealand tertiary hospital catchment area. The secondary aims were to outline a surgical practice in this setting.
Materials and methods: All patients who underwent adrenalectomy or surgical removal of paraganglioma between January 2008 and December 2020 in the Manukau SuperClinic™ area in Auckland, New Zealand, were included. Demographic information, indications for surgery, operative technique, and outcomes were collected.
Results: A total of 78 patients were identified (64 adrenalectomy patients and 14 paraganglioma patients). Functional lesions were most common (n = 45, 70%), with Conn's being most frequent (n = 30). Most adrenalectomies were laparoscopic by transabdominal approach (n = 53, 82%). Paraganglioma patients had more functional lesions (n = 11, 79%), experienced higher rates of open surgery (n = 11, 79%), and overall complications. Māori represented 64% (n = 9) of the 14 patients undergoing surgery for paraganglioma. 56% of these patients had the Succinate dehydrogenase [ubiquinone] iron-sulfur subunit, mitochondrial (SDHB) gene mutation.
Conclusion: Functional lesions were the most common indication to perform an adrenalectomy, with Conn's being the most common. There was a seeming overrepresentation of Māori in the paraganglioma group with a high number of SDHB mutations. Given that SDHB gene mutation is associated with malignancy and poorer prognosis, this merits further study.
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