{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:31:57Z","timestamp":1783488717942,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pheochromocytoma is a rare neuroendocrine tumour that secretes catecholamines and originates in the adrenal gland. Although surgical resection is the only curative therapy for pheochromocytoma, it is associated with a risk of haemodynamic instability (HDI), such as extremely\u00a0high blood pressure and\/or post tumour removal hypotension and shock. We investigated the risk factors for HDI during pheochromocytoma surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Patients<\/jats:title><jats:p>Eighty\u2010two patients who underwent laparoscopic adrenalectomy for pheochromocytoma between July 2002 and February 2020 were examined. We excluded 3 patients with bilateral disease and 11 without detailed 24\u2009h\u00a0urinary data. We defined HDI as systolic blood pressure\u2009\u2265\u2009200\u00a0or &lt;80\u2009mmHg. We investigated the risk factors for HDI during laparoscopic adrenalectomy for pheochromocytoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 29 males and 39 females with a median age of 50.5 years. Tumours were localised on the right adrenal gland in 28 patients and on the left in 40. The median tumour diameter was 37.5\u2009mm and the median pneumoperitoneum time was 93.5\u2009min. Twenty\u2010five out of sixty\u2010eight patients (37%) developed HDI. A multivariate analysis identified diabetes mellitus (DM; odds ratio: 3.834; 95% confidence interval: 1.062\u201313.83; <jats:italic>p<\/jats:italic>\u2009=\u2009.04) as an independent predictor of HDI. In terms of hormonal data, median 24\u2009h\u00a0urinary epinephrine levels (<jats:italic>p<\/jats:italic>\u2009=\u2009.04) and metanephrine levels (<jats:italic>p<\/jats:italic>\u2009=\u2009.01) were significantly higher in the HDI group. DM was also considered as a risk factor for prolonged HDI (<jats:italic>p<\/jats:italic>\u2009=\u2009.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgeons and anaesthesiologists need to be aware of the risk of HDI and its prolongation during laparoscopic adrenalectomy for pheochromocytoma for DM patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14557","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T04:17:02Z","timestamp":1626754622000},"page":"716-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk factors for haemodynamic instability and its prolongation during laparoscopic adrenalectomy for pheochromocytoma"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1196-8642","authenticated-orcid":false,"given":"Toshikazu","family":"Takeda","sequence":"first","affiliation":[{"name":"Department of 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