The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 9: 1561 - 1569

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.09.010

Oncology: Diagnosis, Treatment and Prevention

Comparative study on perioperative comprehensive management and hemodynamic stability in pheochromocytoma and paraganglioma

  • Yuting LI ,
  • Qiaoli YIN ,
  • Yuxiu ZHANG ,
  • Nan LI ,
  • Hao KONG
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  • 1.Department of Anesthesiology，Peking University First Hospital，Beijing 100034，Beijing，Chin
    2Department of Anesthesiology，Peking University First Hospital Ningxia Women and Children's Hospital，Yinchuan 750002，Ningxia，Chin
    a3Department of Critical Care Medicine，Peking University First Hospital，Beijing 100034，Beijing，China

Received date: 2026-01-03

  Online published: 2026-04-29

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Abstract

Objective To compare perioperative clinical characteristics and hemodynamic stability between patients with pheochromocytoma （PCC） and abdominal paraganglioma （PGL）， and to provide evidence-based recommendations for individualized perioperative management. Methods This retrospective study analyzed clinical data from 692 patients who underwent surgical resection at Peking University First Hospital between January 2005 and December 2023. Patients were stratified into the PCC group （n = 535） and the abdominal PGL group （n = 157）. Data were collected using a standardized protocol； missing values were addressed via multiple imputation. Multivariate regression analysis was employed to control for confounding factors. Comparisons were made regarding preoperative baseline characteristics， preparation protocols， intraoperative metrics， and postoperative recovery outcomes. Results Compared to the PCC group， patients with PGL presented with larger tumor diameters （P < 0.001）， higher preoperative systolic （P = 0.019） and diastolic blood pressure （P = 0.023）， elevated plasma norepinephrine levels （P = 0.044）， and reduced plasma metanephrine levels （P = 0.006）. PGL patients required a longer duration of α-blockade （P = 0.015） and showed a higher utilization rate of non-selective α-blockers. Intraoperatively， the PGL group underwent open surgery more frequently （P < 0.001）， experienced longer operative times （P < 0.001）， exhibited higher modified hemodynamic instability scores （P < 0.001）， and sustained greater blood loss （P < 0.001）. Postoperatively， the PGL group demonstrated higher rates of ICU admission and mechanical ventilation， along with prolonged ICU stays， ventilation duration， and hospitalization （all P < 0.05）. No significant difference was observed in the incidence of major complications （P = 0.343）. Multivariate analysis identified PGL as an independent risk factor for intraoperative hemodynamic instability. Conclusion PGL patients face greater perioperative challenges than PCC patients， characterized by inferior hemodynamic stability， increased blood loss， and delayed recovery.

Key words： pheochromocytoma; paraganglioma; perioperative period; hemodynamics; individualized management; systematic management

Cite this article

Yuting LI , Qiaoli YIN , Yuxiu ZHANG , Nan LI , Hao KONG . Comparative study on perioperative comprehensive management and hemodynamic stability in pheochromocytoma and paraganglioma[J]. The Journal of Practical Medicine, 2026 , 42(9) : 1561 -1569 . DOI: 10.3969/j.issn.1006-5725.2026.09.010

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