SURGICAL TREATMENT OF PHEOCHROMOCYTOMA
Keywords:
pheochromocytoma; alpha-blocker; adrenalectomy; central vein of the adrenal gland; adrenal resection.Abstract
This review article briefly summarizes modern ideas about aspects of preoperative preparation, surgical treatment and follow-up of patients with adrenal pheochromocytomas. The main component of preoperative drug preparation is the use of alpha-blockers. The need for their use in all patients is increasingly being challenged, particularly in patients without significant hypertension, and a growing number of publications demonstrate positive results from surgery without the use of alpha-blockers, advocating an individualized approach and their use only for certain indications. In surgical treatment, minimally invasive endoscopic methods of adrenalectomy have become widespread: laparoscopic and retroperitoneoscopic, including the use of their single-port modifications. The key aspect of surgery for pheochromocytomas in the past - the earliest possible intersection of the central vein - with the development of surgical techniques and anesthesia, has ceased to be a mandatory rule for successful adrenalectomy. Despite the significant impact of crossing this vessel on intraoperative hemodynamics, surgical tactics with its later crossing have their justifications and do not lead to worse treatment results.
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