Yamanashi Yuki, Yoshida Yusaku, Nakai Tomoyoshi, Yanagida Juro, Omi Yoko, Horiuchi Kiyomi
Department of Endocrine Surgery, Tokyo Women's Medical University, Tokyo, Japan.
World J Surg. 2024 Dec;48(12):2918-2924. doi: 10.1002/wjs.12368. Epub 2024 Oct 9.
Hypoglycemia after pheochromocytoma resection is one of the most common postoperative complications, with a reported incidence of 12%-43%. In recent years, we have rarely experienced postoperative hypoglycemia after pheochromocytoma surgery at our institution. We reviewed our own experience and examined factors associated with postoperative hypoglycemia in pheochromocytoma patients.
We collected and retrospectively reviewed medical information from 53 patients with pheochromocytoma who underwent initial surgery in our department between 1996 and 2022, who did not receive steroids in the perioperative period and received the same alpha-blocker preoperatively. Subjects were divided into two groups by the midpoint of the study period: Group 1 (G1), 1996-2009; and Group 2 (G2), 2010-2022. The two groups were compared.
Hypoglycemia occurred significantly less often in G2 (0 patients, 0%) than in G1 (7 patients, 28%; p = 0.003). Preoperative diabetes was significantly less frequent in G2 (2 patient, 7.1%) than in G1 (8 patients, 32%; p = 0.03). Preoperative alpha-blocker dosage was significantly higher in G2 than in G1 (p = 0.04). Multivariate logistic regression analysis showed that only alpha-blockers dosage was significantly associated with the occurrence of postoperative hypoglycemia (p = 0.004).
The current study suggest that the alpha-blocker dosage might be related to the lower incidence of postoperative hypoglycemia in Pheochromocytoma patients.
嗜铬细胞瘤切除术后低血糖是最常见的术后并发症之一,报道的发生率为12% - 43%。近年来,我们机构很少遇到嗜铬细胞瘤手术后的术后低血糖情况。我们回顾了自己的经验,并研究了嗜铬细胞瘤患者术后低血糖的相关因素。
我们收集并回顾了1996年至2022年期间在我科接受初次手术的53例嗜铬细胞瘤患者的医疗信息,这些患者在围手术期未接受类固醇治疗,且术前接受相同的α受体阻滞剂。根据研究期的中点将受试者分为两组:第1组(G1),1996 - 2009年;第2组(G2),2010 - 2022年。对两组进行比较。
G2组低血糖发生率(0例,0%)显著低于G1组(7例,28%;p = 0.003)。G2组术前糖尿病发生率(2例,7.1%)显著低于G1组(8例,32%;p = 0.03)。G2组术前α受体阻滞剂剂量显著高于G1组(p = 0.04)。多因素logistic回归分析显示,只有α受体阻滞剂剂量与术后低血糖的发生显著相关(p = 0.004)。
本研究表明,α受体阻滞剂剂量可能与嗜铬细胞瘤患者术后低血糖发生率较低有关。