Journal
JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 19, Pages -Publisher
MDPI
DOI: 10.3390/jcm10194531
Keywords
pheochromocytoma; adrenalectomy; hemodynamic instability; hypertension; hypotension
Categories
Funding
- Suzuki Urologic Research Foundation
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Through systematic search and meta-analysis, this study identified tumor size and urinary norepinephrine as important predictors and risk factors for perioperative hemodynamic instability in pheochromocytoma patients undergoing adrenalectomy.
Objective: To evaluate the risk factors of perioperative hemodynamic instability in pheochromocytoma, we conducted a systematic search of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-analysis. Methods: In April 2021, we systematically searched PubMed, the Cochrane library, and Scopus for relevant studies on the risk factors of perioperative hemodynamic instability of adrenalectomy in patients with pheochromocytoma, and we subjected the findings from those studies to formal meta-analysis. Results: Our systematic review identified 14 studies involving 1725 patients, of which nine studies with 967 patients were eligible for meta-analysis. The results of meta-analysis showed that tumor size (odds ratio (OR): 1.14 for each increased cm, 95% confidence interval (CI) 1.03-1.26, z = 2.57) and urinary norepinephrine (OR, 1.51: 95% CI 1.26-1.81; z = 4.50) were most closely associated with the occurrence of perioperative hemodynamic instability. Conclusion: These findings suggest that tumor size and urinary norepinephrine are important predictors and risk factors for perioperative hemodynamic instability in adrenalectomy for pheochromocytoma. Such findings may be of value to surgeons and anesthesiologists when considering or preparing for this procedure.
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