Published online Nov 27, 2015. doi: 10.5313/wja.v4.i3.83
Peer-review started: May 7, 2015
First decision: June 4, 2015
Revised: August 23, 2015
Accepted: September 25, 2015
Article in press: September 28, 2015
Published online: November 27, 2015
Processing time: 211 Days and 23.1 Hours
Pheochromocytoma is a tumor that originates from either chromaffincells in adrenal medulla or in other paraganglia tissues of the sympathetic nervous system. The perioperative management is quite challenging especially in view of hemodynamic fluctuations. Pheochromocytoma is challenging in view of the impact of excessive and depleted catecholamines in the perioperative period. It requires a through preoperative evaluation and optimization with meticulous intraoperative management. The postoperative period requires vigilance to prevent any untoward complication. In this review we review these concepts based on recent evidence for an optimal outcome.
Core tip: The paper is a comprehensive review of the most important pathophysiological and diagnostic issues, preoperative optimization, and anesthesia management of pheochromocytoma. It describes advanced imaging and biochemical techniques for diagnosis and localisation. Once considered nightmare by anaesthesiologist, pheochromocytoma have improved outcome nowadays due to widely available vasoactive drugs, monitors and perioperative care. Also, availability of laparoscopic and robotic adrenal-sparing adrenalectomy has reduced hospital stay and hastened recovery.