title: Perioperative risk factors, morbidity, and outcome of 145 patients during phaeochromocytoma resection.
abstract: BACKGROUND
  Phaeochromocytoma and paraganglioma resection carries a high perioperative risk. The aim of this study was to determine the risk factors for and frequency of perioperative morbidity and mortality during resection of these tumours.
  
  
  METHODS
  Computerized surgical, medical, and histopathology records, as well as anaesthesia cards for 145 patients undergoing surgery for phaeochromocytoma resection between 1995 and 2009 were analysed retrospectively. Preoperative notes, adverse intraoperative events, and postoperative complications occurring in the 30 days following surgery were recorded. Preoperative phenoxybensamine and propranolol dose, age, sex, ASA score, catecholamine urinary level and profile, tumour weight, duration of surgery, and malignancy and presence of bilateral tumours were investigated to determine their contribution to major intraoperative haemodynamic events. Univariate comparisons were carried out using the student t-test. The Mann-Whitney test was also used to allow for deviation from normality. Logistic regression with backward removal of insignificant variables was used for multivariate analysis. Spearman test was used for correlation analysis.
  
  
  RESULTS
  The only statistically significant factor that increased the probability of intraoperative haemodynamic variability was the duration of surgery (p = 0.025). The most common intraoperative event was transient hypertension, occurring in 59 (40.7%) patients. Sustained hypertension was registered in only 10 (6.9%) patients. No mortality, myocardial infarction, or cerebrovascular incidents were recorded.
  
  
  CONCLUSIONS
  We found that the severity of perioperative haemodynamic changes significantly correlated with the duration of surgery. Our patients had low perioperative morbidity and no mortality.
authors.affiliation: Department of Anaesthesiology, Centre of Endocrine Surgery, University Clinical Centre of Serbia, Belgrade, Serbia. milenakazic@gmail.com
authors.forename: M R
authors.initials: MR
authors.lastname: Kazic
authors.forename: V R
authors.initials: VR
authors.lastname: Zivaljevic
authors.forename: Z B
authors.initials: ZB
authors.lastname: Milan
authors.forename: I R
authors.initials: IR
authors.lastname: Paunovic
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000328:Adult; D000368:Aged; D002395:Catecholamines / Q000652:urine; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000601:surgery; D059035:Perioperative Period; D010673:Pheochromocytoma / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines