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Titolo:
PHEOCHROMOCYTOMA - CONTINUING EVOLUTION OF SURGICAL THERAPY
Autore:
ORCHARD T; GRANT CS; VANHEERDEN JA; IRVIN GL; POMMIER R; DOPPMAN JL;
Indirizzi:
MAYO CLIN & MAYO FDN,DEPT SURG,200 IST ST SW ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,DEPT SURG,200 IST ST SW ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,BIOSTAT SECT ROCHESTER MN 55905
Titolo Testata:
Surgery
fascicolo: 6, volume: 114, anno: 1993,
pagine: 1153 - 1159
SICI:
0039-6060(1993)114:6<1153:P-CEOS>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
FOLLOW-UP; MANAGEMENT; ADRENALECTOMY; LOCALIZATION; DIAGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
T. Orchard et al., "PHEOCHROMOCYTOMA - CONTINUING EVOLUTION OF SURGICAL THERAPY", Surgery, 114(6), 1993, pp. 1153-1159

Abstract

Background. The management of pheochromocytoma has evolved through refinements in diagnosis, localization, and pharmacologic therapy for hemodynamic control both before and during operation. To provide a benchmark for comparison and to assess the feasibility of surgical resection using a posterior or laparoscopic approach, we reviewed the overall management and outcome Of 110 patients who underwent primary resectionof pheochromocytoma or paraganglioma between 1980 and January 1992 atthe Mayo Clinic. Methods. Patient records were reviewed for demographic information, associated conditions, symptoms, laboratory evaluation, localizing techniques, preoperative adrenergic blockade, intraoperative hemodynamics, tumor location, pathologic conditions, and outcome. Results. The most prominent symptoms included headaches, sweating, andpalpitations. Forty-seven percent of patients had sustained hypertension, and classic paroxysmal attacks were present in 72%. The combination of urinary metanephrines and vanillylmandelic acid had a sensitivity of 98% in detecting the disease. The positive and negative predictive values for localization of tumors by computed tomography scan were 95% and 100%, respectively. With routine alpha- and beta-blockade, there were no complications associated with intraoperative hypertension. Perioperative mortality was less than 1% and morbidity was 16%. More than 90% of patients were restored to a condition of normotension; only 20% of these required medication. Conclusions. Surgical resection of these tumors, via a transabdominal approach, can be accomplished safelyand hospitalization usually extends a week. Today the diagnosis, localization, preoperative blockade, intraoperative hemodynamic control, and postoperative management have reached a level sufficient to permit either a posterior or laparoscopic approach, but only if they can be mastered technically.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 18:07:23