Perioperative management of pheochromocytoma: From a dogmatic to a tailored approach

Salvatore Buscemi, Roberto Citarrella, Giorgio Romano, Antonino Agrusa, Giuseppe Di Buono, Claudio Ricci, Laura Alberici, Saverio Selva, Lorenzo Querci, Rocco D’Andrea, Francesco Minni

Risultato della ricerca: Articlepeer review

Abstract

Background: Perioperative management of pheochromocytoma (PCC) remains under debate. Methods: A bicentric retrospective study was conducted, including all patients who underwent laparoscopic adrenalectomy for PCC from 2000 to 2017. Patients were divided into two groups: Group 1 treated with alpha‐blockade, and Group 2, without alfa‐blockers. The primary end point was the major complication rate. The secondary end points were: the need for advanced intraoperative hemostasis, the admission to the intensive care unit (ICU), the length of stay (LOS), systolic (SBP), and diastolic blood pressure (DBP). Univariate and multivariate analysis was conducted. A p‐value < 0.05 was considered statistically significant. Results: Major postoperative complications were similar (p = 0.49). Advanced hemostatic agents were 44.9% in Group 1 and 100% in Group 2 (p < 0.001). In Group 2, no patients were admitted to the ICU, while only 73.5% of Group 1 (p < 0.001) were admitted. The median length of stay was larger in Group 1 than in Group 2 (p = 0.026). At the induction, SBP was 130 mmHg in Group 1, and 115 mmHg (p < 0.001). The pre‐surgery treatment was the only almost statistically significant variable at the multivariate analysis of DBP at the end of surgery. Conclusion: The preoperative use of alfa‐blockers should be considered not a dogma in PCC.
Lingua originaleEnglish
pagine (da-a)3759-
Numero di pagine7
RivistaJournal of Clinical Medicine
Volume10
Stato di pubblicazionePublished - 2021

All Science Journal Classification (ASJC) codes

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