Factors influencing unplanned re-operation of pheochromocytoma and its prevention countermeasures
10.3760/cma.j.issn.1000-6702.2018.02.013
- VernacularTitle:嗜铬细胞瘤非计划再手术原因分析及预防策略探讨
- Author:
Fan JIANG
1
;
Yunfeng HE
;
Yao ZHANG
;
Delin WANG
;
Xiaohou WU
;
Jun PU
Author Information
1. 400016,重庆医科大学附属第一医院泌尿外科
- Keywords:
Pheochromocytoma;
Unplanned reoperation;
Misdiagnosis;
Pre-operative preparation
- From:
Chinese Journal of Urology
2018;39(2):130-134
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the main causes for unplanned re-operation of pheochromocytoma (PCC) and explore the countermeasures on reducing the re-operation rate.Methods The clinical data of 6 patients with pheochromocytoma who underwent an unplanned re-operation were analyzed retrospectively between September 2011 and December 2016 in our hospital.There were 4 males and 2 females with a mean age of 46 years,ranged from 24 to 60 years.Only 1 patient had paroxysmal hypertension and headache,and the other 5 patients had no symptoms or atypical symptoms.Tumors of 3 cases were located in adrenal,and 3 were extra-adrenal PCCs.The average size of tumors was 5.25cm,ranged from 3 to 10 cm.Among the 6 cases,2 cases were diagnosed as PCC preoperatively and underwent adequate preparationwith stable hemodynamics during the first operation,who encountered post-operative bleeding soon after the surgery.Four cases were misdiagnosed,with poor preoperative preparation and operation was aborted.One case was misdiagnosed as bladder carcinoma and underwent transurethral resection.Results All 6 re-operations were performed by urologists.The main causes for unplanned re-operation were as follows:perioperative hemodynamic unstability (50％,3/6),post-operative bleeding (33.3％,2/6),uncertainty of surgical outcome (16.7％,1/6).Conclusions A precise diagnosis and an adequate preoperative preparation are the key to prevent a second-look surgery.An appropriate surgical approach and a complete surgical hemostasis could help lowering the re-operation rate.
