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Bi-national Review of Phaeochromocytoma Care: Is ICU Admission Always Necessary?

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A Correction to this article was published on 01 February 2021

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Abstract

Background

Post-operative management after phaeochromocytoma resection includes monitoring of blood pressure and blood sugar, and vigilance for haemorrhage. Guidelines recommend 24 h of continuous blood pressure monitoring, usually necessitating HDU/ICU admission. We hypothesised that most patients undergoing phaeochromocytoma resection do not require post-operative HDU/ICU admission. We aim to describe current Australian and New Zealand perioperative management of phaeochromocytoma and determine whether it is safe to omit HDU/ICU care for most patients.

Methods

We collected retrospective data on patients undergoing excision of phaeochromocytoma in 12 centres around Australia and New Zealand between 2007 and 2019. Data collected included preoperative medical management, anaesthetic management, vasopressor support, HDU/ICU admission and complications.

Results

A total of 223 patients were included in the study, 173 (77%) of whom were admitted to HDU/ICU post-operatively. The group of patients treated in ICU was similar to the group of patients treated on the ward in terms of demographic and tumour characteristics, and there were significant differences in the proportion of patients admitted to HDU/ICU between centres. Of patients admitted to ICU, 71 (41%) received vasopressor support. This was weaned within 24 h in 55 (77%) patients. Patients with larger tumours (> 6 cm) and a transfusion requirement are more likely to require prolonged inotropic support. Among patients admitted to the ward, there were no complications that required escalation of care.

Conclusions

Although not widespread practice in Australia and New Zealand, it appears safe for the majority of patients undergoing minimally invasive resection of phaeochromocytoma to be admitted to the ward post-operatively.

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Change history

  • 01 February 2021

    In the original version of the article there were formatting errors in Table 4. Following is the corrected table.

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Funding

No funding or other support was received to carry out this work.

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Authors and Affiliations

  1. Endocrine Surgery Unit, Royal Melbourne Hospital, Grattan St. Parkville, Melbourne, VIC, 3050, Australia

    Alexander J. Papachristos, Tiffany J. Cherry & Julie A. Miller

  2. Department of Surgery, University of Melbourne, Melbourne, VIC, Australia

    Julie A. Miller

  3. Department of General Surgery, Fiona Stanley Hospital, Melville, WA, Australia

    Munyaradzi G. Nyandoro & Dean Lisewski

  4. Department of Endocrine Surgery, Christchurch Hospital, Canterbury DHB, Christchurch, New Zealand

    Sarah-Jayne Stevenson & Philippa Mercer

  5. Endocrine Surgery Unit, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia

    Alexander J. Papachristos, Suren Subramaniam, Stan B. Sidhu & Mark S. Sywak

  6. Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia

    Nicholas D. A. Blefari & Christine J. O’Neill

  7. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia

    Nicholas D. A. Blefari & Christine J. O’Neill

  8. Department of General and Endocrine Surgery, Logan Hospital, Logan, QLD, Australia

    Justin S. Gundara

  9. School of Medicine, Griffith University, Gold Coast, QLD, Australia

    Justin S. Gundara

  10. Faculty of Medicine, University of Queensland, Herston, QLD, Australia

    Justin S. Gundara

  11. Department of Surgery, Epworth Healthcare, Melbourne, VIC, Australia

    Julie A. Miller

Authors
  1. Alexander J. Papachristos
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  2. Tiffany J. Cherry
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  12. Justin S. Gundara
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  13. Julie A. Miller
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Correspondence to Alexander J. Papachristos.

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The original online version of this article was revised: There were formatting errors in Table 4.

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Papachristos, A.J., Cherry, T.J., Nyandoro, M.G. et al. Bi-national Review of Phaeochromocytoma Care: Is ICU Admission Always Necessary?. World J Surg 45, 790–796 (2021). https://doi.org/10.1007/s00268-020-05866-8

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  • DOI: https://doi.org/10.1007/s00268-020-05866-8

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