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Article

Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach

by
Salvatore Buscemi
1,
Giuseppe Di Buono
1,
Rocco D’Andrea
2,
Claudio Ricci
3,4,*,
Laura Alberici
3,
Lorenzo Querci
4,
Saverio Selva
3,
Francesco Minni
3,4,
Roberto Citarrella
5,
Giorgio Romano
1 and
Antonino Agrusa
1
1
Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90127 Palermo, Italy
2
Division of Anaestesioloigist, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15-Italia, 40121 Bologna, Italy
3
Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15-Italia, 40121 Bologna, Italy
4
Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, 40121 Bologna, Italy
5
Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(16), 3759; https://doi.org/10.3390/jcm10163759
Submission received: 14 July 2021 / Revised: 16 August 2021 / Accepted: 18 August 2021 / Published: 23 August 2021
(This article belongs to the Special Issue Outcomes and Therapeutic Management of Thyroid Carcinoma)
Versions Notes

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 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.
Keywords: pheochromocytoma; alfa-blockers; perioperative management pheochromocytoma; alfa-blockers; perioperative management

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MDPI and ACS Style

Buscemi, S.; Di Buono, G.; D’Andrea, R.; Ricci, C.; Alberici, L.; Querci, L.; Selva, S.; Minni, F.; Citarrella, R.; Romano, G.; et al. Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach. J. Clin. Med. 2021, 10, 3759. https://doi.org/10.3390/jcm10163759

AMA Style

Buscemi S, Di Buono G, D’Andrea R, Ricci C, Alberici L, Querci L, Selva S, Minni F, Citarrella R, Romano G, et al. Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach. Journal of Clinical Medicine. 2021; 10(16):3759. https://doi.org/10.3390/jcm10163759

Chicago/Turabian Style

Buscemi, Salvatore, Giuseppe Di Buono, Rocco D’Andrea, Claudio Ricci, Laura Alberici, Lorenzo Querci, Saverio Selva, Francesco Minni, Roberto Citarrella, Giorgio Romano, and et al. 2021. "Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach" Journal of Clinical Medicine 10, no. 16: 3759. https://doi.org/10.3390/jcm10163759

APA Style

Buscemi, S., Di Buono, G., D’Andrea, R., Ricci, C., Alberici, L., Querci, L., Selva, S., Minni, F., Citarrella, R., Romano, G., & Agrusa, A. (2021). Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach. Journal of Clinical Medicine, 10(16), 3759. https://doi.org/10.3390/jcm10163759

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