Friedman Lindsay R, Ramamoorthy Bhavishya, Nilubol Naris
Surgical Oncology Program, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10 Room 4-5940, Bethesda, MD 20892, USA.
Best Pract Res Clin Endocrinol Metab. 2025 Jan;39(1):101954. doi: 10.1016/j.beem.2024.101954. Epub 2024 Sep 21.
Significant advances have been made in the past few decades in surgical management and outcomes of patients with pheochromocytoma and paraganglioma. Improvements in preoperative hypertensive control with the implementation of alpha- and beta-adrenergic blockade has resulted in better intra-operative blood pressure control and less incidence of hypertensive crises, which had been a large source of morbidity in the past. Emphasis on anesthesia and surgical team communication has also assisted in minimizing intraoperative hypertensive events at critical points of the operation. Shifting away from open resection, the now standard-of-care laparoscopic and minimally invasive adrenalectomy offers less pain, shorter hospitalizations, and quicker recoveries. Patient underlying germline mutations can guide the timing, approach, and extent of surgery. Postoperative outcomes have significantly improved with recent advancements in perioperative care in addition to regimented biochemical and radiographic surveillance. Here, we highlight the recent advancements in surgical approaches and outcomes for patients with pheochromocytoma and paraganglioma.
在过去几十年中，嗜铬细胞瘤和副神经节瘤患者的外科治疗及预后取得了重大进展。通过实施α和β肾上腺素能阻滞剂改善术前高血压控制，已实现更好的术中血压控制，并减少了高血压危象的发生率，而高血压危象在过去曾是发病的一大主要原因。对麻醉和手术团队沟通的重视也有助于在手术关键点将术中高血压事件降至最低。从开放切除术转向如今的标准治疗方法——腹腔镜和微创肾上腺切除术，带来了更少的疼痛、更短的住院时间和更快的康复。患者潜在的种系突变可指导手术的时机、方法和范围。除了规范的生化和影像学监测外，围手术期护理的最新进展使术后预后得到了显著改善。在此，我们重点介绍嗜铬细胞瘤和副神经节瘤患者外科手术方法及预后的最新进展。
