Management of Patients with Treatment of Pheochromocytoma: A Critical Appraisal

Florence Bihain, Claire Nomine-Criqui, Philippe Guerci, Stephane Gasman, Marc Klein, Laurent Brunaud, Florence Bihain, Claire Nomine-Criqui, Philippe Guerci, Stephane Gasman, Marc Klein, Laurent Brunaud

Abstract

The management of pheochromocytomas has significantly evolved these last 50 years, especially with the emergence of new technologies such as laparoscopic procedures in the 1990s. A preoperative blockade using antihypertensive medications to prevent intraoperative hemodynamic instability and cardiocirculatory events is recommended by current clinical guidelines. However, these guidelines are still based on former experiences and are subject to discussion in the scientific community. The aim of this systematic review was to assess the evolution of the management of pheochromocytomas. Laparoscopic procedure is established as the standard of care in current practices. Preoperative medical preparation should be questioned because it does not significantly improve intraoperative events or the risk of postoperative complications in current clinical practice. Current clinical recommendations should be revised and upgraded to current clinical practices.

Keywords: adrenalectomy; alpha blockade; intraoperative hemodynamic instability; management of pheochromocytoma; mini-invasive surgery; pheochromocytoma; preoperative medical preparation.

Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1
Figure 1
Flow chart according to the PRISMA guidelines: preoperative medical preparation (PMP).
Figure 2
Figure 2
Flow chart according to the PRISMA guidelines: surgical treatment of pheochromocytomas.

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