Features of Management and Surgical Treatment of Malignant Pheochromocytoma

Abstract

Preoperative preparation with alpha-blockers was introduced in the early 1960s to prevent intraoperative hemodynamic instability and thus reduce mortality in high-risk patients. Indeed, surgery at that time consisted of open adrenalectomies with high morbidity and mortality. Current clinical guidelines are based on this early experience. However, new technologies have dramatically reduced mortality in patients with pheochromocytoma. However, clinical guidelines have not evolved at the same rate.

Treatment of pheochromocytomas has changed significantly over the past 50 years, especially with the advent of new technologies such as laparoscopic procedures in the 1990s. Current clinical guidelines recommend the use of antihypertensive drugs to prevent intraoperative hemodynamic instability and cardiovascular complications. However, these recommendations are still based on previous experience and are the subject of debate in the scientific community.