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Präoperative α-Rezeptoren-Blockade beim asymptomatischen Phäochromozytom? Pro

Preoperative α-adrenoceptor block in asymptomatic pheochromocytoma? Pro

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Zusammenfassung

Das Phäochromozytom manifestiert sich in bis zu 90% aller Fälle durch einen permanenten oder labilen Hypertonus. Durch eine massive Katecholaminausschüttung kann es insbesondere während der intraoperativen Tumormanipulation zu lebensbedrohlichen Blutdruckkrisen kommen. Seit den 1950er Jahren wird zur Prävention solcher Ereignisse erfolgreich die präoperative medikamentöse α-Rezeptoren-Blockade durchgeführt. In jüngerer Zeit werden als Nebenbefund von CT- oder MRT-Untersuchungen vermehrt Phäochromozytome diagnostiziert, die bis zu diesem Zeitpunkt asymptomatisch verlaufen sind. Über diese Art des Phäochromozytoms wurde in der Literatur bisher wenig berichtet. Der vorliegende Beitrag beschäftigt sich auf dem Boden der aktuellen Studienlage mit der Frage, ob eine präoperative α-Rezeptoren-Blockade auch beim asymptomatischen Phäochromozytom indiziert ist.

Abstract

In approximately 90% of all cases a pheochromocytoma causes sustained or paroxysmal hypertension. During surgical resection tumor manipulation can lead to excessive catecholamine release with the risk of life-threatening complications. Since the early 1950s a preoperative medical treatment with an α-adrenoceptor blocking agent has been successfully administered for prevention of hemodynamic instability but not all pheochromocytomas are associated with hypertension. Currently the discovery of asymptomatic pheochromocytomas is more frequent than in the time prior to modern imaging techniques (computed tomography, magnetic resonance imaging). There is little information about this type of pheochromocytoma in the literature. This article discusses the question if preoperative α-adrenoceptor block is also indicated in asymptomatic pheochromocytomas based on the current literature.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland

    L. Bracker, S. Rath & M. Bucher

  2. Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland

    H. Dralle

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  1. L. Bracker
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  2. S. Rath
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  3. H. Dralle
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  4. M. Bucher
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Correspondence to L. Bracker.

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Bracker, L., Rath, S., Dralle, H. et al. Präoperative α-Rezeptoren-Blockade beim asymptomatischen Phäochromozytom? Pro. Chirurg 83, 546–550 (2012). https://doi.org/10.1007/s00104-011-2195-4

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  • DOI: https://doi.org/10.1007/s00104-011-2195-4

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