SFEIES24 Poster Presentations Neuroendocrinology (30 abstracts)
A review of outcomes following outpatient alpha-adrenoceptor blockade preoperatively in patients with pheochromocytoma and paraganglioma in a single tertiary centre
Eibhlín Lonergan 1 , Sarah Forde 2 , Stephen Ludgate 1 , Eirena Goulden 1 , Emir Hoti 1 , Ruth Prichard 1 , Ingrid Browne 1 & Rachel K. Crowley 1
1St Vincent’s University Hospital, Dublin, Ireland; 2Rare Disease Clinical Trial Network University College Dublin, Dublin, Ireland
Phaeochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumours, the majority of which secrete excess catecholamines resulting in significant hypertension and tachycardia. Pre-operative blood pressure control with alpha-adrenoceptor blockade is therefore implemented. The aim of the study was to assess the pre-, intra- and post-operative outcomes of patients undergoing outpatient alpha-blockade in our centre. A retrospective chart analysis was conducted on patients who underwent surgical resection of PPGL between 2015 and 2023. Parameters assessed included patient demographics, genetic mutations, pre-operative alpha-blockade agent, total daily dose (TDD), intra-operative blood pressure, length of stay and post-operative complications. To date, data have been collected from charts of 28 patients; 82% had phaeochromocytoma resection; 18% had paraganglioma resection; mean age at surgery 49.6 years. Of 24 patients who had genetic testing in our centre, a genetic mutation was not identified in 74%; SDHB 8%; VHL 8%; MEN2A 4%. Pre-operative functionality assessment revealed secretion of one catecholamine (n = 10), and two or more catecholamines (n = 14). Alpha blockade agent was documented in 26/28 patients. Phenoxybenzamine was the preferred pre-operative alpha blockade agent in 81% (n = 21/26) with a mean TDD of 67 mg, and doxazosin in 19% with a mean TDD of 11 mg. Mean nadir and peak blood pressures were 76/44mmHg and 151/84mmHg, respectively. Median length of stay was 5 days (IQR 2.5-7). There were no blood pressure-related complications. Post-operative complications included fever secondary to atelectasis, hospital acquired pneumonia and intra-operative ureteric injury with post-operative intra-abdominal haematoma. Overall, preliminary data suggest that our local alpha-blockade protocol prior to PPGL resection results in satisfactory intra-operative blood pressure control with few post-operative complications. Data collection is ongoing in our cohort of patients with PPGL.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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