The use of doxazosin before adrenalectomy for pheochromocytoma: is the duration related to intraoperative hemodynamics a
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UROLOGY - ORIGINAL PAPER
The use of doxazosin before adrenalectomy for pheochromocytoma: is the duration related to intraoperative hemodynamics and postoperative complications? Hao Kong1 · Nan Li1 · Jie Tian2,3,4 · Zhengqing Bao2,3,4 · Lu Liu6 · Kai Wu6 · Ying Gao6 · Bo Jin7 · Zheng Zhang2,3,4 · Dong Fang2,3,4,5 · Junqing Zhang6 · Liqun Zhou2,3,4 Received: 3 April 2020 / Accepted: 10 June 2020 © The Author(s) 2020
Abstract Purpose No conclusion exists for the optimum duration of preoperative administration of doxazosin (DOX) before adrenalectomy for pheochromocytoma. The purpose of this study is to investigate whether perioperative hemodynamics and postoperative outcomes are related to the duration of DOX administration. Methods In total, 132 patients managed preoperatively with single α-receptor blocker DOX were enrolled. All patients underwent adrenalectomy for pheochromocytoma in the Department of Urology, Peking University First Hospital, between January 2001 and July 2019. Patients were divided into three groups based on the duration of preoperative administration of DOX: group A (≤14 days), group B (15–30 days), and group C (>30 days). Patient and tumor characteristics, intraoperative hemodynamics, and postoperative outcomes were recorded and compared. Results These patients included 57 men and 75 women, with an average age of 48 years. Clinical characteristics, preoperative hemodynamics, medicine management and surgical approaches were comparable between the three groups. Among the three groups, we found that group C (>30 days) had the lowest intraoperative minimum heart rate [group A vs. group B vs. group C = 60 (52–67) vs. 59 (50–61) vs. 51.5 (50–58.75), p = 0.024] and highest risk of postoperative hypotension requiring vasopressor support [group A vs. group B vs. group C = 14 (20.3%) vs. 12 (27.9%) vs. 10 (50.0%), p = 0.032]. Conclusion The current study indicated that preoperative management of pheochromocytoma with single α-receptor blocker DOX for more than 30 days after final dose adjustment might lead to intraoperative bradycardia and more postoperative hypotension requiring vasopressor support. Thus, our study does not support long-term (over 30 days) preoperative administration of pheochromocytoma with single α-receptor blocker DOX in the final dose. Keywords Doxazosin (DOX) · Pheochromocytoma · Duration · Hemodynamic · Hypotension · Bradycardia
Hao Kong, Nan Li and Jie Tian contributed equally. * Zheng Zhang [email protected]
3
Institute of Urology, Peking University, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China
* Dong Fang [email protected]
4
National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China
* Junqing Zhang [email protected]
5
Andrology Center, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China
6
Department of Endocrinology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China
7
Department of Clinical Laborat
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