Clinical Analysis Of 215 Cases With Adrenal Pheochromocytoma

Objectives: Our investigation analyzes retrospectively the 215 cases suffered from adrenal pheochlomocytoma treated by open or laparoscopic surgery in The second Hospital of HEBEI medical university from December 1986 to December 2008,and in combination with the follow-ups of these cases. Through studying the factor such as epidemiology clinical manifestation,diagnosis technique , surgical technique and prognosis outcomes,to summarize the clinic characteristics of adrenal pheochromocytoma,discuss the safety and current indications of laparoscopic resection of adrenal pheocromocytoma,and improve the diagnosis and treatment of adrenal pheochlomocytoma.Patients and methods: A 22-year retrospective review (1986.12-2008.12) was conducted of all cases with adrenal pheochromocytoma treated by open or laparoscopic surgery. Pheochromocytoma was revealed in all cases by histologic evaluation. The follow-up of all cases was investigated with detailed tables through letters and/or telephones.Results: All the cases confirmed by the operation and the pathology including 210 benign cases (97.7%) and 5 malignant cases (2.3%). The 178 clinical cases have hypertension, the 11 cases have paroxysmal hypertension (6.2%), the 104 cases have long-enduring hypertension along with paroxysmal intensify (58.4%), the most patients of which have the headache, dizziness, hyperidrosis, palpitation. 105 cases are conducted by the urine CA qualitative experiment, 46 cases are positive(43. 8%). 96 cases are conducted by urine 17- hydroxy cerebral cortex steroid and 17- hydroxy cerebral cortex sterone inspection, 42 cases are positive (43. 8%). the ultrasound inspects 207 cases, 199 cases are positive (96.1%); CT inspects 210 cases, 210 cases are positive (100%); MRI inspects 97 cases, 90 cases are positive (92.8%); 131I-MIBG inspects 5 cases, 5 cases are positive (100%). 180 cases who are used by Alpha the adrenalin acceptor blocking agent to drope the blood pressure may keep 140/90mmHg. In the application of Alpha acceptor blocking agent's foundation, adds the Beta acceptor-blocking agent to 53 cases with tachycardia, the heart rate may be controlled below 90/minutes. Give the blood volume beginning at 3~15 days before operation, the fluid infusion is about 2500~3000ml/day. In 215 cases, 85 cases for the peritoneoscope surgery, 34 cases for the opening surgery passed through the abdomen admission passage, 96 cases for the opening surgery passed through retroperitoneal admission passage. 210 cases patients safely passed the encircle surgery time, 2 cases patients dead because of multi-organ function failure.Conclusions: The procedures of the qualitative and locative diagnosis of adrenal pheochromocytoma included clinical manifestations, biochemistry examination and imaging investigation. Surgical management was the only means for cure and preoperative preparation was extremely important. There are probability to be potential malignant in adrenal pheochromocytoma, so postoperative long-term follow-up was recommended.