Hypoglycemia after resection of pheochromocytoma
Background Hypoglycemia after resection of pheochromocytoma is a rare and poorly understood complication thought to be secondary to rebound hyperinsulinemia and increased peripheral glucose uptake. We examined the incidence of this complication and aimed to identify predisposing risk factors. Method...
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| Veröffentlicht in: | Surgery 2014-12, Vol.156 (6), p.1404-1409 |
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| creator | Chen, Yufei, MD Hodin, Richard A., MD Pandolfi, Chiara Ruan, Daniel T., MD McKenzie, Travis J., MD |
| description | Background Hypoglycemia after resection of pheochromocytoma is a rare and poorly understood complication thought to be secondary to rebound hyperinsulinemia and increased peripheral glucose uptake. We examined the incidence of this complication and aimed to identify predisposing risk factors. Methods Patients who underwent pheochromocytoma resection between 1993 and 2013 at 2 large academic medical centers were identified retrospectively from a research patient data registry. The primary end point was postoperative hypoglycemia defined as blood glucose |
| doi_str_mv | 10.1016/j.surg.2014.08.020 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1629956091</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S003960601400498X</els_id><sourcerecordid>1629956091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-2b71a761521256bc0124e51e17146d1cca591fd5466e6101d40933c36fc7779d3</originalsourceid><addsrcrecordid>eNp9kUFr3DAQhUVpaDab_oEewh57sTsjS_IKSqEsbRII5JAEchNaebzRxra2kh3wv4_NJj300NNcvvfgfcPYF4QcAdW3fZ6GuMs5oMhhnQOHD2yBsuBZWSj8yBYAhc4UKDhlZyntAUALXH9ip1wKqTSHBYOr8RB2zeio9XZl657iKlIi1_vQrUK9OjxRcE8xtMGNfWjtOTupbZPo89tdsoffv-43V9nN7eX15udN5gRin_FtibZUKDlyqbYOkAuSSFiiUBU6Z6XGupJCKVLTmkqALgpXqNqVZamrYsm-HnsPMfwZKPWm9clR09iOwpAMKq61VKBxQvkRdTGkFKk2h-hbG0eDYGZTZm9mU2Y2ZWBtJlNT6OKtf9i2VP2NvKuZgO9HgKaVL56iSc5T56jycdJjquD_3__jn7hrfOedbZ5ppLQPQ-wmfwZN4gbM3fyr-VUoAIRePxavLOGNQw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1629956091</pqid></control><display><type>article</type><title>Hypoglycemia after resection of pheochromocytoma</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Chen, Yufei, MD ; Hodin, Richard A., MD ; Pandolfi, Chiara ; Ruan, Daniel T., MD ; McKenzie, Travis J., MD</creator><creatorcontrib>Chen, Yufei, MD ; Hodin, Richard A., MD ; Pandolfi, Chiara ; Ruan, Daniel T., MD ; McKenzie, Travis J., MD</creatorcontrib><description>Background Hypoglycemia after resection of pheochromocytoma is a rare and poorly understood complication thought to be secondary to rebound hyperinsulinemia and increased peripheral glucose uptake. We examined the incidence of this complication and aimed to identify predisposing risk factors. Methods Patients who underwent pheochromocytoma resection between 1993 and 2013 at 2 large academic medical centers were identified retrospectively from a research patient data registry. The primary end point was postoperative hypoglycemia defined as blood glucose <55 mg/dL. Results A total of 213 patients underwent resection of pheochromocytoma for a total of 215 operations. Nine patients (4.2%) experienced postoperative hypoglycemia, with 8 of 9 episodes occurring in the first 24 hours. Patients who developed hypoglycemia were more likely to have greater preoperative 24-hour urinary metanephrine (4,726 vs 2,461 μg/24 h, P = .05) and experienced longer operative times (270 vs 142 minutes, P < .01) with larger neoplasms (7.6 vs 4.6 cm, P = .02). Postoperatively, patients with hypoglycemia required intensive care level monitoring more frequently (88.9% vs 34.5%, P < .01), but there was no difference in duration of hospital stay (5 vs 3 days, P = .10). Conclusion Our data demonstrate that hypoglycemia is a rare complication after resection of pheochromocytoma and may be more common in patients with epinephrine-predominant neoplasms and longer operative times.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2014.08.020</identifier><identifier>PMID: 25456920</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Academic Medical Centers ; Adrenal Gland Neoplasms - diagnosis ; Adrenal Gland Neoplasms - surgery ; Adrenalectomy - adverse effects ; Adrenalectomy - methods ; Adult ; Aged ; Analysis of Variance ; Blood Glucose - analysis ; Cohort Studies ; Confidence Intervals ; Female ; Follow-Up Studies ; Humans ; Hypoglycemia - epidemiology ; Hypoglycemia - etiology ; Hypoglycemia - physiopathology ; Incidence ; Male ; Middle Aged ; Odds Ratio ; Pheochromocytoma - diagnosis ; Pheochromocytoma - surgery ; Postoperative Complications - epidemiology ; Postoperative Complications - physiopathology ; Prognosis ; Registries ; Retrospective Studies ; Risk Assessment ; Statistics, Nonparametric ; Surgery ; Time Factors</subject><ispartof>Surgery, 2014-12, Vol.156 (6), p.1404-1409</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-2b71a761521256bc0124e51e17146d1cca591fd5466e6101d40933c36fc7779d3</citedby><cites>FETCH-LOGICAL-c411t-2b71a761521256bc0124e51e17146d1cca591fd5466e6101d40933c36fc7779d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S003960601400498X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25456920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Yufei, MD</creatorcontrib><creatorcontrib>Hodin, Richard A., MD</creatorcontrib><creatorcontrib>Pandolfi, Chiara</creatorcontrib><creatorcontrib>Ruan, Daniel T., MD</creatorcontrib><creatorcontrib>McKenzie, Travis J., MD</creatorcontrib><title>Hypoglycemia after resection of pheochromocytoma</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background Hypoglycemia after resection of pheochromocytoma is a rare and poorly understood complication thought to be secondary to rebound hyperinsulinemia and increased peripheral glucose uptake. We examined the incidence of this complication and aimed to identify predisposing risk factors. Methods Patients who underwent pheochromocytoma resection between 1993 and 2013 at 2 large academic medical centers were identified retrospectively from a research patient data registry. The primary end point was postoperative hypoglycemia defined as blood glucose <55 mg/dL. Results A total of 213 patients underwent resection of pheochromocytoma for a total of 215 operations. Nine patients (4.2%) experienced postoperative hypoglycemia, with 8 of 9 episodes occurring in the first 24 hours. Patients who developed hypoglycemia were more likely to have greater preoperative 24-hour urinary metanephrine (4,726 vs 2,461 μg/24 h, P = .05) and experienced longer operative times (270 vs 142 minutes, P < .01) with larger neoplasms (7.6 vs 4.6 cm, P = .02). Postoperatively, patients with hypoglycemia required intensive care level monitoring more frequently (88.9% vs 34.5%, P < .01), but there was no difference in duration of hospital stay (5 vs 3 days, P = .10). Conclusion Our data demonstrate that hypoglycemia is a rare complication after resection of pheochromocytoma and may be more common in patients with epinephrine-predominant neoplasms and longer operative times.</description><subject>Academic Medical Centers</subject><subject>Adrenal Gland Neoplasms - diagnosis</subject><subject>Adrenal Gland Neoplasms - surgery</subject><subject>Adrenalectomy - adverse effects</subject><subject>Adrenalectomy - methods</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Blood Glucose - analysis</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypoglycemia - epidemiology</subject><subject>Hypoglycemia - etiology</subject><subject>Hypoglycemia - physiopathology</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Pheochromocytoma - diagnosis</subject><subject>Pheochromocytoma - surgery</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Time Factors</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFr3DAQhUVpaDab_oEewh57sTsjS_IKSqEsbRII5JAEchNaebzRxra2kh3wv4_NJj300NNcvvfgfcPYF4QcAdW3fZ6GuMs5oMhhnQOHD2yBsuBZWSj8yBYAhc4UKDhlZyntAUALXH9ip1wKqTSHBYOr8RB2zeio9XZl657iKlIi1_vQrUK9OjxRcE8xtMGNfWjtOTupbZPo89tdsoffv-43V9nN7eX15udN5gRin_FtibZUKDlyqbYOkAuSSFiiUBU6Z6XGupJCKVLTmkqALgpXqNqVZamrYsm-HnsPMfwZKPWm9clR09iOwpAMKq61VKBxQvkRdTGkFKk2h-hbG0eDYGZTZm9mU2Y2ZWBtJlNT6OKtf9i2VP2NvKuZgO9HgKaVL56iSc5T56jycdJjquD_3__jn7hrfOedbZ5ppLQPQ-wmfwZN4gbM3fyr-VUoAIRePxavLOGNQw</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Chen, Yufei, MD</creator><creator>Hodin, Richard A., MD</creator><creator>Pandolfi, Chiara</creator><creator>Ruan, Daniel T., MD</creator><creator>McKenzie, Travis J., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Hypoglycemia after resection of pheochromocytoma</title><author>Chen, Yufei, MD ; Hodin, Richard A., MD ; Pandolfi, Chiara ; Ruan, Daniel T., MD ; McKenzie, Travis J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-2b71a761521256bc0124e51e17146d1cca591fd5466e6101d40933c36fc7779d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Academic Medical Centers</topic><topic>Adrenal Gland Neoplasms - diagnosis</topic><topic>Adrenal Gland Neoplasms - surgery</topic><topic>Adrenalectomy - adverse effects</topic><topic>Adrenalectomy - methods</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Blood Glucose - analysis</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypoglycemia - epidemiology</topic><topic>Hypoglycemia - etiology</topic><topic>Hypoglycemia - physiopathology</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Pheochromocytoma - diagnosis</topic><topic>Pheochromocytoma - surgery</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Yufei, MD</creatorcontrib><creatorcontrib>Hodin, Richard A., MD</creatorcontrib><creatorcontrib>Pandolfi, Chiara</creatorcontrib><creatorcontrib>Ruan, Daniel T., MD</creatorcontrib><creatorcontrib>McKenzie, Travis J., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Yufei, MD</au><au>Hodin, Richard A., MD</au><au>Pandolfi, Chiara</au><au>Ruan, Daniel T., MD</au><au>McKenzie, Travis J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypoglycemia after resection of pheochromocytoma</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>156</volume><issue>6</issue><spage>1404</spage><epage>1409</epage><pages>1404-1409</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Background Hypoglycemia after resection of pheochromocytoma is a rare and poorly understood complication thought to be secondary to rebound hyperinsulinemia and increased peripheral glucose uptake. We examined the incidence of this complication and aimed to identify predisposing risk factors. Methods Patients who underwent pheochromocytoma resection between 1993 and 2013 at 2 large academic medical centers were identified retrospectively from a research patient data registry. The primary end point was postoperative hypoglycemia defined as blood glucose <55 mg/dL. Results A total of 213 patients underwent resection of pheochromocytoma for a total of 215 operations. Nine patients (4.2%) experienced postoperative hypoglycemia, with 8 of 9 episodes occurring in the first 24 hours. Patients who developed hypoglycemia were more likely to have greater preoperative 24-hour urinary metanephrine (4,726 vs 2,461 μg/24 h, P = .05) and experienced longer operative times (270 vs 142 minutes, P < .01) with larger neoplasms (7.6 vs 4.6 cm, P = .02). Postoperatively, patients with hypoglycemia required intensive care level monitoring more frequently (88.9% vs 34.5%, P < .01), but there was no difference in duration of hospital stay (5 vs 3 days, P = .10). Conclusion Our data demonstrate that hypoglycemia is a rare complication after resection of pheochromocytoma and may be more common in patients with epinephrine-predominant neoplasms and longer operative times.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25456920</pmid><doi>10.1016/j.surg.2014.08.020</doi><tpages>6</tpages></addata></record> |
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| subjects | Academic Medical Centers Adrenal Gland Neoplasms - diagnosis Adrenal Gland Neoplasms - surgery Adrenalectomy - adverse effects Adrenalectomy - methods Adult Aged Analysis of Variance Blood Glucose - analysis Cohort Studies Confidence Intervals Female Follow-Up Studies Humans Hypoglycemia - epidemiology Hypoglycemia - etiology Hypoglycemia - physiopathology Incidence Male Middle Aged Odds Ratio Pheochromocytoma - diagnosis Pheochromocytoma - surgery Postoperative Complications - epidemiology Postoperative Complications - physiopathology Prognosis Registries Retrospective Studies Risk Assessment Statistics, Nonparametric Surgery Time Factors |
| title | Hypoglycemia after resection of pheochromocytoma |
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