Bihain Florence, Nomine-Criqui Claire, Guerci Philippe, Gasman Stephane, Klein Marc, Brunaud Laurent
Department of Gastrointestinal, Visceral, Metabolic, and Cancer Surgery (CVMC), University Hospital of Nancy (CHRU Nancy), University of Lorraine, Rue du Morvan, 54511 Vandoeuvre-les-Nancy, France.
Inserm UMR_S1256 Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 54500 Nancy, France.
Cancers (Basel). 2022 Aug 9;14(16):3845. doi: 10.3390/cancers14163845.
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.
在过去的50年里,嗜铬细胞瘤的治疗方法有了显著的发展,尤其是20世纪90年代腹腔镜手术等新技术的出现。目前的临床指南建议术前使用抗高血压药物进行阻断,以预防术中血流动力学不稳定和心脏循环事件。然而,这些指南仍然基于以前的经验,在科学界存在争议。本系统评价的目的是评估嗜铬细胞瘤治疗方法的演变。腹腔镜手术已成为当前治疗的标准方法。术前药物准备值得质疑,因为在当前临床实践中,它并不能显著改善术中情况或降低术后并发症的风险。当前的临床建议应根据当前临床实践进行修订和更新。