Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report
Autor(a) principal: | |
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Data de Publicação: | 2002 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/2168 |
Resumo: | Pheocromocytomas are rare malignant tumors which synthesize, store and secrete catecholamines, 85% of them are found in the adrenal. It is often possible to do a curative resection. However, surgical excision of the tumors can be potentially fatal due to acute and severe hemodynamic changes, that could happen during surgery. Laparoscopic surgery is the treatment of choice, because it allows for a less traumatic management of tumor and the better access approach of the adrenal vein, resulting in lower release of catecholamines, that may raise due to the pneumoperitoneum. The anesthetic management in preoperative and perioperative remains a challenge, because these hemodynamic changes differ from one patient to another, regardless of any prior preparation. We report the case of a young patient with tumor in right adrenal with mild clinical conditions upon admitance, not requiring blocking agent in the preoperative. Cardiovascular alterations during pneumoperitonium and tumor management were swiftly controlled by direct arteriolar and venous agent nitruprusside sodium and beta-blocker esmolol. A bibliographic review on different anaesthetic techniques and monitoring is presented. |
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Hemodynamic changes during pheochromocytoma laparoscopic resection. Case reportAlterações hemodinâmicas durante ressecção de feocromocitoma por videolaparoscopia. Relato de casoFeocromocitomaNeoplasias das Glândulas Supra-RenaisHemodinâmicaAnestesiaVideolaparoscopiaPheochromocytomaAdrenal Gland NeoplasmsHemodynamicsAnesthesiaVideolaparoscopyPheocromocytomas are rare malignant tumors which synthesize, store and secrete catecholamines, 85% of them are found in the adrenal. It is often possible to do a curative resection. However, surgical excision of the tumors can be potentially fatal due to acute and severe hemodynamic changes, that could happen during surgery. Laparoscopic surgery is the treatment of choice, because it allows for a less traumatic management of tumor and the better access approach of the adrenal vein, resulting in lower release of catecholamines, that may raise due to the pneumoperitoneum. The anesthetic management in preoperative and perioperative remains a challenge, because these hemodynamic changes differ from one patient to another, regardless of any prior preparation. We report the case of a young patient with tumor in right adrenal with mild clinical conditions upon admitance, not requiring blocking agent in the preoperative. Cardiovascular alterations during pneumoperitonium and tumor management were swiftly controlled by direct arteriolar and venous agent nitruprusside sodium and beta-blocker esmolol. A bibliographic review on different anaesthetic techniques and monitoring is presented.Feocromocitomas são tumores malignos raros que sintetizam, armazenam e secretam catecolaminas. 85% destes localizam-se na supra-renal. Freqüentemente são passíveis de ressecção curativa. Entretanto, a extirpação desses tumores pode ser potencialmente fatal devido às alterações hemodinâmicas agudas e severas que podem ocorrer no perioperatório. A cirurgia videolaparoscópica é o tratamento de eleição, permitindo uma manipulação menos traumática do tumor e acesso à veia adrenal com menor liberação de catecolaminas. Entretanto, a produção do pneumoperitônio pode levar ao aumento destas. O manejo anestésico no pré e perioperatório continua sendo um desafio, pois as alterações hemodinâmicas variam de um paciente para outro, independente do preparo prévio. Relatamos o caso de um paciente jovem com tumor na supra-renal direita, internado com quadro de pouca repercussão clínica, no qual não foram utilizados bloqueadores adrenérgicos no pré-operatório. As alterações cardiovasculares que ocorrem durante a confecção do pneumoperitônio para ressecção da massa tumoral foram prontamente controladas com o vasodilatador nitroprussiato de sódio e o beta-bloqueador esmolol. Uma revisão bibliográfica sobre as várias técnicas anestésicas e monitorização empregadas no perioperatório foi realizada.INCA2002-12-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRelato de Casoapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/216810.32635/2176-9745.RBC.2002v48n4.2168Revista Brasileira de Cancerologia; Vol. 48 No. 4 (2002): Oct./Nov./Dec.; 551-554Revista Brasileira de Cancerologia; Vol. 48 Núm. 4 (2002): oct./nov./dic.; 551-554Revista Brasileira de Cancerologia; v. 48 n. 4 (2002): out./nov./dez.; 551-5542176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/2168/1334Soares Netto, José Jorge Abrahão, Renata Tavares, Martinelis info:eu-repo/semantics/openAccess2021-11-29T20:36:58Zoai:rbc.inca.gov.br:article/2168Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2021-11-29T20:36:58Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report Alterações hemodinâmicas durante ressecção de feocromocitoma por videolaparoscopia. Relato de caso |
title |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
spellingShingle |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report Soares Netto, José Jorge Feocromocitoma Neoplasias das Glândulas Supra-Renais Hemodinâmica Anestesia Videolaparoscopia Pheochromocytoma Adrenal Gland Neoplasms Hemodynamics Anesthesia Videolaparoscopy |
title_short |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
title_full |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
title_fullStr |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
title_full_unstemmed |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
title_sort |
Hemodynamic changes during pheochromocytoma laparoscopic resection. Case report |
author |
Soares Netto, José Jorge |
author_facet |
Soares Netto, José Jorge Abrahão, Renata Tavares, Martinelis |
author_role |
author |
author2 |
Abrahão, Renata Tavares, Martinelis |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Soares Netto, José Jorge Abrahão, Renata Tavares, Martinelis |
dc.subject.por.fl_str_mv |
Feocromocitoma Neoplasias das Glândulas Supra-Renais Hemodinâmica Anestesia Videolaparoscopia Pheochromocytoma Adrenal Gland Neoplasms Hemodynamics Anesthesia Videolaparoscopy |
topic |
Feocromocitoma Neoplasias das Glândulas Supra-Renais Hemodinâmica Anestesia Videolaparoscopia Pheochromocytoma Adrenal Gland Neoplasms Hemodynamics Anesthesia Videolaparoscopy |
description |
Pheocromocytomas are rare malignant tumors which synthesize, store and secrete catecholamines, 85% of them are found in the adrenal. It is often possible to do a curative resection. However, surgical excision of the tumors can be potentially fatal due to acute and severe hemodynamic changes, that could happen during surgery. Laparoscopic surgery is the treatment of choice, because it allows for a less traumatic management of tumor and the better access approach of the adrenal vein, resulting in lower release of catecholamines, that may raise due to the pneumoperitoneum. The anesthetic management in preoperative and perioperative remains a challenge, because these hemodynamic changes differ from one patient to another, regardless of any prior preparation. We report the case of a young patient with tumor in right adrenal with mild clinical conditions upon admitance, not requiring blocking agent in the preoperative. Cardiovascular alterations during pneumoperitonium and tumor management were swiftly controlled by direct arteriolar and venous agent nitruprusside sodium and beta-blocker esmolol. A bibliographic review on different anaesthetic techniques and monitoring is presented. |
publishDate |
2002 |
dc.date.none.fl_str_mv |
2002-12-30 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Relato de Caso |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2168 10.32635/2176-9745.RBC.2002v48n4.2168 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/2168 |
identifier_str_mv |
10.32635/2176-9745.RBC.2002v48n4.2168 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2168/1334 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
INCA |
publisher.none.fl_str_mv |
INCA |
dc.source.none.fl_str_mv |
Revista Brasileira de Cancerologia; Vol. 48 No. 4 (2002): Oct./Nov./Dec.; 551-554 Revista Brasileira de Cancerologia; Vol. 48 Núm. 4 (2002): oct./nov./dic.; 551-554 Revista Brasileira de Cancerologia; v. 48 n. 4 (2002): out./nov./dez.; 551-554 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
instname_str |
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
instacron_str |
INCA |
institution |
INCA |
reponame_str |
Revista Brasileira de Cancerologia (Online) |
collection |
Revista Brasileira de Cancerologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
repository.mail.fl_str_mv |
rbc@inca.gov.br |
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1797042249578577920 |