Abstract:

Pheochromocytoma and paraganglioma （PPGL） are rare neuroendocrine tumors characterized not only by hemodynamic instability but also by fluctuations in blood glucose levels during the perioperative period. These features are closely associated with significant variations in catechromamine secretion. Hypoglycemia is a common postoperative complication in patients with PPGL and is primarily attributed to rebound insulin secretion and enhanced insulin sensitivity following tumor resection. Postoperative hypoglycemia requires heightened clinical attention due to its often subtle presentation and potential for serious complications. Known risk factors include the presence of an epinephrine-secreting tumor， prolonged operative time， larger tumor size， and a history of end-stage renal disease. Therefore， it is essential to identify high-risk patients preoperatively， ensure meticulous intraoperative monitoring， and implement timely postoperative interventions. This article provides a comprehensive review of recent advances in the epidemiology， underlying mechanisms， clinical diagnosis， management strategies， and prognosis of postoperative hypoglycemia in PPGL. Importantly， it introduces novel research directions and conceptual frameworks for the first time， including the optimal timing and dosage of α-receptor antagonists， potential applications of micro-dose glucagon therapy， and molecular mechanisms with targeted interventions in glucose metabolism regulation. This review aims to address the current lack of standardized perioperative management protocols and to offer innovative and clinically relevant guidance for healthcare professionals.

Key words: pheochromocytoma, paraganglioma, catecholamine, hypoglycemia