COMPLEX DIAGNOSTICS AND SURGICAL TACTICS IN BILATERAL PHEOCHROMOCYTOMAJournal: I.P. Pavlov Russian Medical Biological Herald (Vol.24, No. 3)
Publication Date: 2016-09-28
Authors : Sadriev O.N.; Gaibov A.D.; Kalmykov E.L.; Anvarova S.S.;
Page : 118-125
Keywords : pheochromocytoma; metanephrines; α-blockers; adrenalectomy;
The aim - determination of surgical treatment, and particularly the management of patients with bilateral pheochromocytomas. The paper analyzes the results of a comprehensive diagnostics and treatment of 8 patients with bilateral pheochromocytomas. Pheochromocytoma diagnosis was based on clinical data and the results of ultrasound, CT, and the definition of metanephrines levels. Despite the typical clinical manifestations pheochromocytomas only one patient was diagnosed up to 1 year from the moment of occurrence of the first clinical signs of the disease. In other cases, for various reasons (errors in the diagnosis of primary care physicians, late treatment of patients, long-term independent use of various antihypertensive drugs) was observed late diagnosis of the disease. In all patients preoperative applied selective α-blocker - doxazosin (4-12 mg / day.) To stabilize the state and achieve the desired antihypertensive effect. When surgical treatment pheochromocytomas bilateral localization authors adhere to the two-stage tactics, removing the first stage of a large magnitude on the tumor. The interval between the stages of the operation was 2-13 months. Special attention is attached to the nature of drug replacement therapy. Selected treatment-diagnostic tactics in the late period allowed the authors to achieve good results in most cases. Failure to follow the mode of application of preparations aimed at hormone replacement therapy, one death was observed. With the authors recommend the need for a rigorous medical examination of patients and proper conduct of hormone replacement therapy, the aim of adrenal insufficiency prevention and treatment.
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