Progress in surgical approaches and outcomes of patients with pheochromocytoma and paraganglioma.

Lindsay R Friedman, Bhavishya Ramamoorthy, Naris Nilubol
Author Information
  1. Lindsay R Friedman: Surgical Oncology Program, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10 Room 4-5940, Bethesda, MD 20892, USA. Electronic address: lindsay.friedman@nih.gov.
  2. Bhavishya Ramamoorthy: Surgical Oncology Program, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10 Room 4-5940, Bethesda, MD 20892, USA. Electronic address: bhavishya.ramamoorthy@vcuhealth.org.
  3. Naris Nilubol: Surgical Oncology Program, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10 Room 4-5940, Bethesda, MD 20892, USA. Electronic address: naris.nilubol@nih.gov.

Abstract

Significant advances have been made in the past few decades in surgical management and outcomes of patients with pheochromocytoma and paraganglioma. Improvements in preoperative hypertensive control with the implementation of alpha- and beta-adrenergic blockade has resulted in better intra-operative blood pressure control and less incidence of hypertensive crises, which had been a large source of morbidity in the past. Emphasis on anesthesia and surgical team communication has also assisted in minimizing intraoperative hypertensive events at critical points of the operation. Shifting away from open resection, the now standard-of-care laparoscopic and minimally invasive adrenalectomy offers less pain, shorter hospitalizations, and quicker recoveries. Patient underlying germline mutations can guide the timing, approach, and extent of surgery. Postoperative outcomes have significantly improved with recent advancements in perioperative care in addition to regimented biochemical and radiographic surveillance. Here, we highlight the recent advancements in surgical approaches and outcomes for patients with pheochromocytoma and paraganglioma.

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