Approach to the Patient: Perioperative Management of the Patient with Pheochromocytoma or Sympathetic Paraganglioma

Annika M A Berends, Michiel N Kerstens, Jacques W M Lenders, Henri J L M Timmers*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Pheochromocytomas and sympathetic paraganglioma (PPGL) are rare chromaffin cell tumors originating in the adrenal medulla and sympathetic paraganglia, respectively, which share the capacity to synthesize and release catecholamines. The incidence of PPGL has increased in recent years. Surgical resection is the only curative treatment for PPGL. Management of patients with PPGL is complex and should be done by a specialized multidisciplinary team in centers with broad expertise. Surgical resection of a PPGL is a high-risk procedure for which optimal pretreatment with antihypertensive drugs is required in combination with state-of-the-art surgical procedures and anesthesiological techniques. In this article we discuss the underlying evidence and the pros and cons of presurgical medical preparation. Finally, the areas of uncertainty and controversies in this field are addressed.

Original languageEnglish
Article numberdgaa441
Pages (from-to)3088-3102
Number of pages15
JournalJournal of Clinical Endocrinology and Metabolism
Volume105
Issue number9
DOIs
Publication statusPublished - Sep-2020

Keywords

  • perioperative management
  • pheochromocytoma
  • sympathetic paraganglioma
  • alpha-receptor blockade
  • CALCIUM-CHANNEL BLOCKERS
  • LAPAROSCOPIC ADRENALECTOMY
  • HEMODYNAMIC INSTABILITY
  • ANESTHETIC MANAGEMENT
  • HISTAMINE-RELEASE
  • PREOPERATIVE PREPARATION
  • HYPERTENSIVE RESPONSE
  • ALPHA-METHYLTYROSINE
  • HALOTHANE ANESTHESIA
  • EUROPEAN-SOCIETY

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