ОСОБЕННОСТИ ВЕДЕНИЯ И ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПРИ ЗЛОКАЧЕСТВЕННОЙ ФЕОХРОМОЦИТОМЕ
Ключевые слова:
феохромоцитома; лечениефеохромоцитомы; альфа блокада; предоперационная медицинская подготовка; интраоперационная гемодинамическая нестабильность; малоинвазивная хирургия ; адреналэктомияАннотация
Предоперационная подготовка с альфа-арноблокаторами была внедрена в начале 1960-х годов для предотвращения интраоперационной гемодинамической нестабильности и, следовательно, снижения смертности у пациентов с высоким риском осложнений. Действительно, хирургия в то время состояла из открытых адреналэктомий с высоким уровнем заболеваемости и смертности. Текущие клинические рекомендации основаны на этом раннем опыте. Однако новые технологии позволили резко снизить уровень смертности у пациентов с феохромоцитомой. Однако клинические рекомендации развивались не с той же скоростью.
Лечение феохромоцитом значительно изменилось за последние 50 лет, особенно с появлением новых технологий, таких как лапароскопические процедуры в 1990-х годах. В текущих клинических рекомендациях для предотвращения интраоперационной гемодинамической нестабильности и кардиоциркуляторных осложнений рекомендуется использовать антигипертензивные препараты. Однако эти рекомендации по-прежнему основаны на предыдущем опыте и являются предметом обсуждения в научном сообществе.
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