Anesthetic management of laparoscopic pheochromocytoma surgery: A case report

Abstract

Pheochromocytoma is a neuroendocrine tumor of the adrenal medulla chromaffin cells. It has a variable clinic indicating symptoms such as hypertension, headache, sweating, palpitations, and anxiety. Determination of vanillylmandelic acid in urine and metanephrines are accepted as the most sensitive tests for diagnosis. Computerized tomography and magnetic resonance imaging cad be used for tumor localization. Anesthetic induction and surgical manipulations usually lead to the catastrophic release of catecholamines. Thus, accurate preoperative pharmacological preparation is vital in these patients. Treatment is a complete surgical resection of the primary tumor and, if possible, metastases after banning dangerous fluctuations in hemodynamic through α-blockers. Today, laparoscopic adrenalectomy has begun to replace open surgery as a standard treatment method in many adrenal diseases. J Clin Exp Invest 2014; 5 (2): 443-446

Keywords

• Pheochromocytoma, Adrenalectomy, Laparoscopic Surgery

Laparoskopik feokromasitoma cerrahisinde anestezi yönetimi: Olgu sunumu

Öz

Feokromasitoma adrenal medulla kromafin hücreleri kaynaklı nöroendokrin bir tümördür. Hipertansiyon, baş ağrısı, terleme, çarpıntı ve anksiyete gibi semptomlar gösteren değişken bir kliniğe sahiptir. Tanıda idrarda vanilmandelik asit ve metanefrinlerin tayini en duyarlı test olarak kabul edilmektedir. Tümörün lokalizasyonunun belirlenmesinde bilgisayarlı tomografi ve magnetik rezonans görüntüleme kullanılabilir. Anestezi indüksiyonu ve cerrahi manipulasyonlar katekolaminlerin katastrofik salınımına yol açmaktadır. Bu nedenle doğru preoperatif farmakolojik hazırlık bu hastalarda hayati önem taşımaktadır. Tedavi, α-blokörlerle tehlikeli hemodinamik dalgalanmayı engelledikten sonra primer tümörün ve mümkün ise metastazların tam cerrahi rezeksiyondur. Günümüzde laparoskopik adrenalektomi birçok adrenal kitlede standart tedavi yöntemi olarak açık cerrahinin yerini almaya başlamıştır.

Anahtar Kelimeler

• Feokromasitoma, adrenalektomi, laparoskopik cerrahi

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