This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Plouin, P.-F. Articles by Chatellier, G. Search for Related Content PubMed PubMed Citation Articles by Plouin, P.-F. Articles by Chatellier, G. Pubmed/NCBI databases Medline Plus Health Information Pheochromocytoma

Factors Associated with Perioperative Morbidity and Mortality in Patients with Pheochromocytoma: Analysis of 165 Operations at a Single Center¹

Departments of Hypertension, Urology, and Medical Informatics, Hôpital Broussais-Saint Joseph, 75908 Paris Cedex 15; and Gestion Essais Cliniques, Etudes Statistiques Monitoring, 92120 Montrouge, France

Address all correspondence and requests for reprints to: Dr. Pierre-François Plouin, Hypertension Unit, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris Cedex 15, France. E-mail: pierre-francois.plouin{at}egp.ap-hop-paris.fr

To identify preoperative factors associated with 30-day morbidity and mortality after pheochromocytoma surgery, we carried out an external review of the records of all patients undergoing pheochromocytoma surgery from 1975 to 1997 at a single center. One hundred and forty-seven patients, including 23 with malignant tumors at the time of the first operation, underwent 165 operations. Death, resection of a neighboring organ, further surgery, secondary transfer to an intensive care unit, and any events associated with a surgical stay exceeding 10 days were defined as complications. Mortality and morbidity were 4 of 165 (2.4%) and 38 of 161 (23.6%), respectively. Morbidity included 13 spleen resections and hematomas. Spleen complications were not related to tumor location, but were probably due to the operative strategy used, a transperitoneal complete abdominal exploration including both adrenal glands. Complications were independently associated with preoperative systolic blood pressure [odds ratio (OR), 1.14/cm Hg], urinary metanephrine excretion (OR, 1.18/10 µmol·day), and with the number of operations (repeat vs. first operation OR, 5.36). In conclusion, pheochromocytoma resection consistently involves a risk of complications. Spleen damage should be prevented by complete preoperative localization studies and an elective or laparoscopic surgical approach. Careful blood pressure control should help prevent complications. Patients with high secretion tumors and those undergoing repeat intervention are at high risk of complications and should be referred to centers familiar with pheochromocytoma management.

This article has been cited by other articles:

				J. T. Adler, G. Y. Meyer-Rochow, H. Chen, D. E. Benn, B. G. Robinson, R. S. Sippel, and S. B. Sidhu Pheochromocytoma: Current Approaches and Future Directions Oncologist, July 1, 2008; 13(7): 779 - 793. [Abstract] [Full Text] [PDF]

				D. Pasquali, V. Rossi, G. Conzo, G. Pannone, P. Bufo, A. De Bellis, A. Renzullo, G. Bellastella, A. Colao, G. Vallone, et al. Effects of somatostatin analog SOM230 on cell proliferation, apoptosis, and catecholamine levels in cultured pheochromocytoma cells J. Mol. Endocrinol., June 1, 2008; 40(6): 263 - 271. [Abstract] [Full Text] [PDF]

				K. Pacak Preoperative Management of the Pheochromocytoma Patient J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4069 - 4079. [Abstract] [Full Text] [PDF]

				N. S. Tarant, R. G. Dacanay, B. W. Mecklenburg, S. D. Birmingham, E. Lujan, and R. Green Acute Appendicitis in a Patient with Undiagnosed Pheochromocytoma Anesth. Analg., February 1, 2006; 102(2): 642 - 643. [Abstract] [Full Text] [PDF]

				K. O. Rynn, F. L. Hughes, and B. Faley An Emergency Department Approach to Drug Treatment of Hypertensive Urgency and Emergency Journal of Pharmacy Practice, October 1, 2005; 18(5): 363 - 376. [Abstract] [PDF]

				L. Amar, A. Servais, A.-P. Gimenez-Roqueplo, F. Zinzindohoue, G. Chatellier, and P.-F. Plouin Year of Diagnosis, Features at Presentation, and Risk of Recurrence in Patients with Pheochromocytoma or Secreting Paraganglioma J. Clin. Endocrinol. Metab., April 1, 2005; 90(4): 2110 - 2116. [Abstract] [Full Text] [PDF]

				J. Favier, P.-F. Plouin, P. Corvol, and J.-M. Gasc Angiogenesis and Vascular Architecture in Pheochromocytomas : Distinctive Traits in Malignant Tumors Am. J. Pathol., October 1, 2002; 161(4): 1235 - 1246. [Abstract] [Full Text] [PDF]

				Q.-Y. Duh Editorial: Evolving Surgical Management for Patients with Pheochromocytoma J. Clin. Endocrinol. Metab., April 1, 2001; 86(4): 1477 - 1479. [Full Text]