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Araujo-Castro M, Pascual-Corrales E, Lorca Álvaro J, Mínguez Ojeda C, Pian H, Ruz-Caracuel I, Sanjuanbenito Dehesa A, Serrano Romero A, Alonso-Gordoa T, Molina-Cerrillo J, Gómez Dos Santos V. Manejo quirúrgico y posquirúrgico de paragangliomas abdominales y feocromocitomas. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Araujo-Castro M, Pascual-Corrales E, Nattero Chavez L, Martínez Lorca A, Alonso-Gordoa T, Molina-Cerrillo J, Lorca Álvaro J, Mínguez Ojeda C, Redondo López S, Barberá Durbán R, Polo López R, Moreno Mata N, Caballero Silva U, Pian H, Ruz-Caracuel I, Sanjuanbenito Dehesa A, Gómez Dos Santos V, Serrano Romero AB. Protocol for presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas: a multidisciplinary approach. J Endocrinol Invest 2021; 44:2545-2555. [PMID: 34304388 DOI: 10.1007/s40618-021-01649-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To offer a practical guide for the presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas (PGLs). METHODS This protocol was based on a comprehensive review of the literature and on our own multidisciplinary team's experience from managing pheochromocytoma and sympathetic PGLs at a referral center. RESULTS Patients with pheochromocytomas and sympathetic paragangliomas (PGLs) may develop potentially life-threatening complications, especially during surgical procedures. A complete biochemical, radiological, genetic, and cardiological assessment is recommended in the preoperative stage as it provides an evaluation of the risk of surgical complications and malignancy, allowing individualization of the presurgical treatment. Treatment with α-blockade and proper volume expansion in the preoperative stage significantly reduces the perioperative morbidity. During surgery, the anesthesiologist should look for a deep anesthetic level that inhibits the cardiovascular effects of catecholamines to minimize the risk of intraoperative complications. CONCLUSIONS An optimal presurgical evaluation of pheochromocytomas/ sympathetic PGL requires a multidisciplinary approach, including a complete hormonal, radiological, cardiac, genetic, and functioning evaluation in most cases. A proper preoperative evaluation in combination with strict blood pressure and heart rate control, and blood volume status optimization, will significantly reduce the risk of intraoperative and perioperative complications. In those patients who unfortunately develop intraoperative complications, the role of the anesthesiologist is essential since the selection of the appropriate management has a direct impact on morbimortality reduction.
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Affiliation(s)
- M Araujo-Castro
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain.
| | - E Pascual-Corrales
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain
| | - L Nattero Chavez
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain
| | - A Martínez Lorca
- Department of Nuclear Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - T Alonso-Gordoa
- Department of Medical Oncology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Molina-Cerrillo
- Department of Medical Oncology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Lorca Álvaro
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Mínguez Ojeda
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S Redondo López
- Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Barberá Durbán
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Polo López
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - N Moreno Mata
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - U Caballero Silva
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - H Pian
- Department of Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - I Ruz-Caracuel
- Department of Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A Sanjuanbenito Dehesa
- Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - V Gómez Dos Santos
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A B Serrano Romero
- Department of Anesthesia, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Iacobone M, Torresan F. Laparoscopic Resection of Para-Aortic Paraganglioma. VideoEndocrinology 2021. [DOI: 10.1089/ve.2020.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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