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Khirurgii

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Year 2015 Vol. 23 No 5

GENERAL & SPECIAL SURGERY

Î.N. SADRIEV 1, À.D. GAIBOV 1,2

COMPLEX DIAGNOSTICS AND CURRENT PRINCIPLES OF PHEOCHROMOCYTOMA TREATMENT

Republican Scientific Center of Cardiovascular Surgery1,
Avicenna Tajik State Medical University2,
Dushanbe
The Republic of Tajikistan

Objectives. To evaluate the results of complex diagnostics and surgical treatment of patients with pheochromocytoma.
Methods. Treatment results of 25 patients with pheochromocytoma (PCC) have been analyzed (15 (60%) females and 10 (40%) males). The average age of patients was 35,9±4,2 years. Average duration on the disease was 4,6±1,7 years. Diagnosis was confirmed by ultrasonography (US), computerized tomography (CT) and determination of metanephrines (MN) and vanillylmandelic acid (VMA) levels. Depending on the preoperative tactics all patients were divided into 2 groups. Α-blockers of short-acting (phentolamine) were used to the patients of the first group (n=8) only during the operation. Α-blockers (doxazosin) were administered to the patiens of the second group (n=17) in the preoperative period.
Results. In all cases a reliable increase of MN and VMA levels was registered. No difference was found in studying MN excretion level depending on the tumor size and disease duration. Sensitivity of US and CT in PCC diagnostics made up 92% and 100%, and specificity 52% and 91,3%, respectively. In the 1st group 2 (25%) patients died due to the development of «uncontrolled hemodynamics» syndrome. There was no lethal outcome in the 2nd group (ð<0,05). Complications were observed in 5 (21,7%) patients during the operation (n=2) and in the early postoperative period (n=3). There was 1 (4,3%) lethal outcome after adrenalectomy. In the long-term period (1-8 yrs) good results were obtained in 21 (91,3%) operated patients and satisfactory – in 1 (4,3%).
Conclusion. The use of minimally invasive techniques in the treatment of pheochromocytoma can help reduce the incidence of postoperative complications and duration of hospitalization. In all cases the preoperative preparation should be carried out with the use of α-blockers. The patients are required clinical medical examination and proper conduction of hormone replacement therapy to prevent and treat adrenal insufficiency.

Keywords: pheochromocytoma, diagnostics, operative treatment, postoperative complications, metanephrines, α-adrenoblockers, adrenalectomy
p. 506-514 of the original issue
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Address for correspondence:
734003, Republic of Tadzhikistan,
g. Dushanbe, prospekt Rudaki, d. 139,
Tadzhikskiy gosudarstvennyiy
meditsinskiy universitet imeni Abuali ibni Sino,
kafedra khirurgicheskih bolezney ¹2.
tel.: 992 915 25 00 55;
e-mail: sadriev_o_n@mail.ru,
Sadriev Okildzhon Nemadzhonovich
Information about the authors:
Sadriev O.N. A leading researcher of the Republican Scientific Center of Cardiovascular Surgery.
Gaibov A.D. Corresponding member of the Academy of Medical Sciences of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, MD, professor of the surgical diseases chair ¹2 of Avicenna Tajik State Medical University, professor and tutor of the vascular surgery department of the Republican Scientific Center of Cardiovascular Surgery.
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