Clinical features, perioperative care and anesthetic management of multiple endocrine neoplasia associated with pheochromocytoma
- VernacularTitle:含嗜铬细胞瘤的多发性内分泌腺瘤的临床特征及围术期麻醉管理
- Author:
Xiangyang GUO
;
Ailun WO
;
Jingbo YAN
- Publication Type:Journal Article
- Keywords:
Pheochromocytoma;
Multiple endocrine neoplasia;
Anesthesia
- From:
Chinese Journal of Anesthesiology
1995;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of multiple endocrine neoplasia ( MEN) associated with pheochromocytoma and anesthetic management during perioperative period. Methods Medical records of 12 patients who were operated upon for MEN associated with pheochromocytoma in our hospital from April 1977 to April 2001 were reviewed retrospectively. The demographic data, clinical manifestation, family history, biochemical examinations, type of MEN, the order of different surgical procedures for patients who had multiple operations and changes in hemodynamics were collected and analyzed. Results The 12 patients accounted for 5.6% (12/213) of the patients with pheochromocytoma admitted in the same period. Nine of the 12 patients had a diagnosis of MEN Ⅱa (Sipple syndrome) and three mixed MEN. Four patients with MEN type II a had a positive familial history. Five patients with other coexistent endocrine disorders underwent the excision of pheochromocytoma first, and only two of them had hypertensive symptoms when they were admitted. Seven patients without a history of hypertensive episodes received surgical treatment for pheochromocytoma as a second operation. The excision of pheochromocytoma was performed under general anesthesia ( in 8 patients ) or epidural anesthesia (in 4 patients). Marked hemodynamic fluctuations were recorded in 8 patients. There was no death.Conclusion Pheochromocytoma associated with other endocrine disorders in MEN may manifest itself as the main clinical symptom or most frequently as an occult tumor. Recognition of this feature is of importance to the improvement of diagnosis and treatment of both pheochromocytoma and MEN.
