PD03-09 WHAT ARE THE PREOPERATIVE RISK FACTORS OF HEMODYNAMIC INSTABILITY DURING ADRENALECTOMY FOR PHEOCHROMOCYTOMA?

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You have accessJournal of UrologyCME1 Apr 2023PD03-09 WHAT ARE THE PREOPERATIVE RISK FACTORS OF HEMODYNAMIC INSTABILITY DURING ADRENALECTOMY FOR PHEOCHROMOCYTOMA? Mokhtar Bibi, Yassine Ouanes, Kays Chaker, Mohamed Anouer Madani, Yosri Messoudi, Boutheina Mosbahi, Selma Trabelsi, Kheireddine Mourad Dali, Moez Rahoui, and yassine Nouira Mokhtar BibiMokhtar Bibi More articles by this author , Yassine OuanesYassine Ouanes More articles by this author , Kays ChakerKays Chaker More articles by this author , Mohamed Anouer MadaniMohamed Anouer Madani More articles by this author , Yosri MessoudiYosri Messoudi More articles by this author , Boutheina MosbahiBoutheina Mosbahi More articles by this author , Selma TrabelsiSelma Trabelsi More articles by this author , Kheireddine Mourad DaliKheireddine Mourad Dali More articles by this author , Moez RahouiMoez Rahoui More articles by this author , and yassine Nouira yassine Nouira More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003220.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adrenalectomy for pheochromocytoma is considered to be a challenging procedure because of the risk of hemodynamic instability (HI), which is poorly defined and unpredictable. Our study aimed to determine the predictive factors for perioperative HI in patients undergoing unilateral adrenalectomy for pheochromocytoma. METHODS: Between January 2005 and December 2021, 45 patients underwent unilateral adrenalectomy for pheochromocytoma in department of urology La Rabta Hospital. HI was defined as an occurrence of intraoperative episodes of systolic blood pressure above 200 mmHg, mean arteral pressure under 60 mmHg or vasoactive drug administration. Patients were divided into 2 groups depending on presence or absence of intraoperative HI. Patient demographics, tumor characteristics and perioperative hemodynamics were noted. A multivariable logistic regression analysis was performed to determine the independent preoperative risk factors for HI. RESULTS: There was no postoperative mortality, and HI was noted 71.1% (32 patients). Open and laparoscopic adrenalectomy were performed in 36 and 9 patients respectively. Mean tumor size was 54.52 mm. Univariate analysis showed that gender, tumor size, tumoral necroses, B blockers treatment were significantly associated with Hi (p=0.019, p=0.00 01, p=0.0001, p=0.01, respectively). IH was correlated with Systolic blood pressure at incision, adrenal artery clamping and tumour removal (p=0.018, p=0.001, p=0.046, p=0.048, respectively). The multivariate logistic regression analysis showed that tumor size was an independent risk factors for intraoperative hemodynamic instability (OR 2.79, 95% CI: 1-61.8, p=0.008). CONCLUSIONS: Tumour size was the independant predictive factor with hemodynamic instability during adrenalectomy for pheochromocytoma. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e78 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mokhtar Bibi More articles by this author Yassine Ouanes More articles by this author Kays Chaker More articles by this author Mohamed Anouer Madani More articles by this author Yosri Messoudi More articles by this author Boutheina Mosbahi More articles by this author Selma Trabelsi More articles by this author Kheireddine Mourad Dali More articles by this author Moez Rahoui More articles by this author yassine Nouira More articles by this author Expand All Advertisement PDF downloadLoading ...