Adrenalectomy and Abdominal Paraganglioma Surgery at an Ethnically Diverse New Zealand Center: Māori Ethnicity Frequent Amongst Paraganglioma Patients

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.