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Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach
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-bl...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397195/ https://www.ncbi.nlm.nih.gov/pubmed/34442056 http://dx.doi.org/10.3390/jcm10163759 |
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author | Buscemi, Salvatore Di Buono, Giuseppe D’Andrea, Rocco Ricci, Claudio Alberici, Laura Querci, Lorenzo Selva, Saverio Minni, Francesco Citarrella, Roberto Romano, Giorgio Agrusa, Antonino |
author_facet | Buscemi, Salvatore Di Buono, Giuseppe D’Andrea, Rocco Ricci, Claudio Alberici, Laura Querci, Lorenzo Selva, Saverio Minni, Francesco Citarrella, Roberto Romano, Giorgio Agrusa, Antonino |
author_sort | Buscemi, Salvatore |
collection | PubMed |
description | 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 intra-operative 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. |
format | Online Article Text |
id | pubmed-8397195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83971952021-08-28 Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach Buscemi, Salvatore Di Buono, Giuseppe D’Andrea, Rocco Ricci, Claudio Alberici, Laura Querci, Lorenzo Selva, Saverio Minni, Francesco Citarrella, Roberto Romano, Giorgio Agrusa, Antonino J Clin Med Article 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 intra-operative 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. MDPI 2021-08-23 /pmc/articles/PMC8397195/ /pubmed/34442056 http://dx.doi.org/10.3390/jcm10163759 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Buscemi, Salvatore Di Buono, Giuseppe D’Andrea, Rocco Ricci, Claudio Alberici, Laura Querci, Lorenzo Selva, Saverio Minni, Francesco Citarrella, Roberto Romano, Giorgio Agrusa, Antonino Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title | Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title_full | Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title_fullStr | Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title_full_unstemmed | Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title_short | Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach |
title_sort | perioperative management of pheochromocytoma: from a dogmatic to a tailored approach |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397195/ https://www.ncbi.nlm.nih.gov/pubmed/34442056 http://dx.doi.org/10.3390/jcm10163759 |
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