Meta-analysis of α-blockade versus no blockade before adrenalectomy for phaeochromocytoma

• Verfasst von: Schimmack, Simon [VerfasserIn]
• Verfasst von: Kaiser, Jörg [VerfasserIn]
• Verfasst von: Probst, Pascal [VerfasserIn]
• Verfasst von: Kalkum, Eva [VerfasserIn]
• Verfasst von: Diener, Markus K. [VerfasserIn]
• Verfasst von: Strobel, Oliver [VerfasserIn]
• Titel: Meta-analysis of α-blockade versus no blockade before adrenalectomy for phaeochromocytoma
• Verf.angabe: S. Schimmack, J. Kaiser, P. Probst, E. Kalkum, M.K. Diener, O. Strobel
• E-Jahr: 2020
• Jahr: 05 January 2020
• Umfang: 7 S.
• Fussnoten: Gesehen am 30.01.2020 ; Im Titel ist "alpha" als griechischer Buchstabe dargestellt
• Titel Quelle: Enthalten in: The British journal of surgery
• Ort Quelle: Oxford [u.a.] : Oxford University Press, 1913
• Jahr Quelle: 2020
• Band/Heft Quelle: 107(2020), 2, Seite 102-108
• ISSN Quelle: 1365-2168
• DOI: doi:10.1002/bjs.11348
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1688907769
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background Preoperative α-blockade in phaeochromocytoma surgery is recommended by all guidelines to prevent intraoperative cardiocirculatory events. The aim of this meta-analysis was to assess the benefit of such preoperative treatment compared with no treatment before adrenalectomy for phaeochromocytoma. Methods A systematic literature search was undertaken in MEDLINE, Web of Science and CENTRAL without language restrictions. Randomized and non-randomized comparative studies investigating preoperative α-blockade in phaeochromocytoma surgery were included. Data on perioperative safety, effectiveness and outcomes were extracted. Pooled results were calculated as an odds ratio or mean difference with 95 per cent confidence interval. Results A total of four retrospective comparative studies were included investigating 603 patients undergoing phaeochromocytoma surgery. Mortality, cardiovascular complications, mean maximal intraoperative systolic and diastolic BP, and mean maximal intraoperative heart rate did not differ between patients with or without α-blockade. The certainty of the evidence was very low owing to the inferior quality of studies. Conclusion This meta-analysis has shown a lack of evidence for preoperative α-blockade in surgery for phaeochromocytoma. RCTs are needed to evaluate whether preoperative α-blockade can be abandoned.