[Emergent treatment for latent pheochromocytoma diagnosed during operation: a report of 11 Cases].
OBJECTIVE
Latent pheochromocytoma (PHOE) is a rare disease with no symptom of hypertension, which is easily to be misdiagnosed before operation. There occurs dramatic fluctuations of blood pressure during surgical resection, and the risk of surgery for these patients is rather high. This study was to summarize our experiences in handling emergent treatment for latent PHOE.


METHODS
Clinical data of 11 patients underwent latent PHOE resection from Sep. 2002 to Jun. 2007 were analyzed.


RESULTS
Of the 11 patients, 9 received general anesthesia, 2 received epidural anesthesia first and were changed to general anesthesia during operation; 8 patients underwent open surgery, 3 underwent laparoscopic adrenalectomy. The average of the maximal intraoperative systolic blood pressure (SBP) was 253 mmHg (range, 165-330 mmHg) and the average of the minimal SBP was 92 mmHg (range, 55-120mmHg). The SBP of 3 patients exceeded 300 mmHg. Four patients had Intraoperative hypotension (SBP<90 mmHg). According to the intraoperative blood pressure, latent PHOE was diagnosed. The emergent treatments included rapidly performed monitoring of anesthesia, fluid expansion, administration of vasoactive drugs to control the blood pressure, and operation under the supervision and cooperation of anesthesia. All operations were successfully completed. The average operative time and blood loss were 135 min (range, 90-180 min) and 280 mL (range, 100-500 mL), respectively. No patient required a blood transfusion. No heart failure, pulmonary edema, and other serious complications appeared. All cases were confirmed PHOE pathologically after operation and the mean hospitalization time was 8 days (range, 6-11 days). All the patients were cured and discharged.


CONCLUSIONS
With full coordination with anesthesia and skillful surgical techniques, the surgery of latent PHOE diagnosed during operation can be accomplished at one time.
Chen
Zhuang-Fei
ZF
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.
Qin
Zi-Ke
ZK
Zhou
Fang-Jian
FJ
Han
Hui
H
Liu
Zhuo-Wei
ZW
Zhang
Ding-Zuan
DZ
Yang
Jian-An
JA
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult