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Successful outcomes in pheochromocytoma surgery in the modern era
J C Ulchaker1, D A Goldfarb, E L Bravo
1Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
Purpose:
We describe our experience with surgical management, complications and treatment outcome of histologically confirmed pheochromocytoma.
Materials And Methods:
The records of 113 patients who underwent surgical excision of pheochromocytoma were reviewed and assessed for preoperative medical treatment, intraoperative findings, postoperative hospitalization and complications.
Results:
There were no surgical mortalities. Average length of stay in the intensive care unit was 1.2 days. There were only 6 major cardiovascular complications all of which occurred in patients who received preoperative medications, including 5 with alpha blockade. Patients receiving no preoperative alpha blockade required an average of 956 cc less in total intraoperative fluids, which approached statistical significance, and 479 cc less fluids on postoperative day 1, which was statistically significant.
Conclusions:
Preoperative alpha-adrenergic blockade is not essential in pheochromocytoma patients. Calcium channel blockers are just as effective and safer when used as the primary mode of antihypertensive therapy. Surgery for pheochromocytoma is safe in the modern era.