Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2022) 86 P10 | DOI: 10.1530/endoabs.86.P10

SFEBES2022 Poster Presentations Adrenal and Cardiovascular (66 abstracts)

Practices in perioperative management of patients with pheochromocytoma and paraganglioma: a Scoping Review

Andreea Bojoga 1,2 , Harveer Narula 3 & Sabapathy Balasubramanian 4,5

1National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania; 2“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 3University of Buckingham Medical School, Birmingham, United Kingdom; 4Directorate of General Surgery, Sheffield Teaching Hospitals and Department of Oncology and Metabolism, Sheffield, United Kingdom; 5University of Sheffield, Sheffield, United Kingdom

Introduction: There is variation in practice with regards to preoperative optimization protocols and postoperative management in pheocromocytoma and related paraganglioma (PPGL). We aimed to review the literature on perioperative strategies to reduce morbidity and mortality following surgery for PPGL and enhance understanding of optimal approaches.

Methods: Two databases were systematically searched in January 2020 for terms related to perioperative management of PPGL. Articles were screened and included if they described preoperative strategies, intraoperative manoeuvres or interventions and postoperative regimens, both pharmacological and non-pharmacological.

Results: The initial search identified 625 articles, of which 89 studies met the inclusion criteria, including 5387 patients, of which 91% were observational, and 21% evaluated the impact of preoperative interventions by including a control group; 48% were published in the last decade. Alpha-blockade was mentioned in 90% of studies: phenoxybenzamine (66%), doxazosin (26%), prazosin (26%). 40% of studies mentioned either use of preoperative high fluid intake, intravenous fluids and/or high-sodium diet. Eleven studies reported hypoglycemia episodes, which occurred mainly in the first 24 hours after surgery, but ranged between 60 min and 162 hours after surgery. Postoperative vasopressors were usually used for sustained hypotension which was not corrected by intravenous saline replacement. In 11 studies, only 14.6% of 895 patients required postoperative vasopressors for sustained hypotension.

No. of studies
Intraoperative monitoringIntraarterial catheter32
Central venous catheter placement21
Pulmonary artery catheter9
Intraoperative managementHypertensive surgesMost common: sodium nitroprusside (22)
HypotensionIntravenous fluids use (37)
Colloids use (22)
Vasopressors use (23)

Conclusions: The variation of practices described in this paper underlines the lack of consensus on the optimal strategy in practices of perioperative management of pheocromocytoma. These practices are based largely on local experiences and retrospective studies with the inherent biases they carry thus resulting in poor strength of recommendations in current guidelines.

Volume 86

Society for Endocrinology BES 2022

Harrogate, United Kingdom
14 Nov 2022 - 16 Nov 2022

Society for Endocrinology 

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