Cervical paragangliomas: experience of 114 cases in 14 years

Başel, Halil; Bozan, Nazım

doi:10.1016/j.bjorl.2018.05.001

Cited by 11 publications

(7 citation statements)

References 24 publications

(20 reference statements)

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“…First proposed in 1970, the Shamblin classification, a three-group classification system based on operative risk, has been widely used for risk stratification before surgical interventions for CBTs [ 5 , 6 ]. Shamblin type I tumors do not compromise carotid vessels, and excision can be easily performed with little difficulty.…”

Section: Introductionmentioning

confidence: 99%

Perioperative blood pressure and heart rate alterations after carotid body tumor excision: a retrospective study of 108 cases

Chen

Zhang

et al. 2022

BMC Anesthesiol

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Background Arising from chemoreceptor cells, carotid body tumors (CBTs) are rare neoplasms associated with hemodynamics. Perioperative changes in blood pressure (BP) and heart rate (HR) are not completely understood. Methods This retrospective, observational, controlled study included all CBT patients from 2013 to 2018 in Peking Union Medical College Hospital. Perioperative changes in BP/HR within or between unilateral/bilateral/control groups were investigated. Perioperative details across Shamblin types were also assessed. Results This study included 108 patients (116 excised CBTs). The postoperative systolic BP and HR increased in both unilateral (mean difference of systolic BP = 5.9mmHg, 95% CI 3.1 ~ 8.6; mean difference of HR = 3.7 bpm, 95% CI 2.6 ~ 4.9) and bilateral (mean difference of systolic BP = 10.3mmHg, 95% CI 0.6 ~ 19.9; mean difference of HR = 8.4 bpm, 95% CI 0.5 ~ 16.2) CBT patients compared with the preoperative measures. Compared with control group, the postoperative systolic BP increased (difference in the alteration = 6.3mmHg, 95% CI 3.5 ~ 9.0) in unilateral CBT patients; both systolic BP (difference in the alteration = 9.2mmHg, 95% CI 1.1 ~ 17.3) and HR (difference in the alteration = 5.3 bpm, 95% CI 1.0 ~ 9.6) increased in bilateral CBT patients. More CBT patients required extra antihypertensive therapy after surgery than controls (OR = 2.5, 95% CI 1.14 ~ 5.5). Maximum tumor diameter, intraoperative vascular injury, continuous vasoactive agent requirement, total fluid volume, transfusion, estimated blood loss, operation duration, postoperative pathology, overall complications, and intensive care unit/hospital lengths of stay significantly varied among Shamblin types. Conclusion CBT excision may be associated with subtle perioperative hemodynamic changes. Perioperative management of CBT patients necessitates careful assessment, full preparation and close postoperative monitoring.

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Section: Introductionmentioning

confidence: 99%

Perioperative blood pressure and heart rate alterations after carotid body tumor excision: a retrospective study of 108 cases

Chen

Zhang

et al. 2022

BMC Anesthesiol

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“…According to Luna Ortiz et al, 22 this maneuver is performed in 13% to 32% of cases. Recently, it was reported to have been carried out in 28.8% of cases in a series of 104 patients 23 . Ligation of the external carotid is not part of our habitual clinical practice, although we were obliged to do it for one patient, who, curiously, was a Shamblin grade II case.…”

Section: Discussionmentioning

confidence: 99%

Simple and complex carotid paragangliomas. Three decades of experience and literature review

et al. 2020

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Background: Carotid paragangliomas are rare tumors. They are usually unique, non-secreting, resectable, and benign. However, additional rare cases of complex tumors (bilateral, secretory, nonresectable, or malignant) complicate the management and final outcomes. Methods: Records of paragangliomas from our hospital are reviewed. Criteria defining complex paragangliomas have been previously defined. These are compared with those of the simple group. Results: Fifty patients, two groups: simple (n = 39) and complex (n = 11). The patients in the complex group were significantly younger (47.7 vs 63.8 years). Postoperative nerve complications (45.4% vs 6.3%) and mortality during follow-up (27.3% vs 0%) were significantly more common in the complex group. Vascular complications (0% vs 3.1%) and early mortality (0%) were similarly in both groups. Conclusions: Patients with complex carotid paragangliomas are heterogeneous. The former are younger, exhibit a high degree of diagnostic and therapeutic complexity, and have poorer morbidity and mortality. Surgical experience and interdisciplinary collaboration are essential.

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“…The secondary objective was to summarize and assess the perioperative management details of CBT patients using the Shamblin classi cation. The Shamblin classi cation, a three-group classi cation system based on operative risk, has been widely used for risk strati cation before surgical interventions for CBTs [5][6] . Shamblin type I tumors do not compromise carotid vessels, and excision can be easily performed with little di culty.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Blood Pressure and Heart Rate Alterations After Carotid Body Tumor Excision: A Retrospective Study of 108 Cases

Chen

et al. 2021

Preprint

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Background Arising from chemoreceptor cells, carotid body tumors (CBTs) are rare neoplasms associated with hemodynamics. Postoperative changes in blood pressure (BP) and heart rate (HR) are not completely understood. Methods This retrospective, observational, controlled study included all CBT patients from 2013 to 2018 in Peking Union Medical College Hospital. Postoperative changes in BP/HR within or between unilateral/bilateral/control groups were investigated. Perioperative details across Shamblin types were also assessed. Results This study included 108 patients (116 excised CBTs). The postoperative systolic BP and HR increased in both unilateral and bilateral CBT patients compared with the preoperative measures. Compared with control group, the postoperative systolic BP increased (difference in the alteration = 6.3, 95% CI 3.5 ~ 9.0, p < 0.001) in unilateral CBT patients; both systolic BP (difference in the alteration = 9.2, 95% CI 1.1 ~ 17.3, p = 0.027) and HR (difference in the alteration = 5.3, 95% CI 1.0 ~ 9.6, p = 0.016) increased in bilateral CBT patients. More CBT patients required extra antihypertensive therapy after surgery than controls (OR = 2.5, 95% CI 1.14 ~ 5.5, p = 0.024). Maximum tumor diameter, intraoperative vascular injury, continuous vasoactive agent requirement, total fluid volume/transfusion, estimated blood loss, operation duration, postoperative pathology, overall complications, and intensive care unit/hospital lengths of stay significantly varied among Shamblin types. Conclusions CBT excision may be associated with subtle postoperative hemodynamic changes. Perioperative management of CBT patients necessitates careful assessment, full preparation and close postoperative monitoring.

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Cervical paragangliomas: experience of 114 cases in 14 years

Abstract: Surgery is the definitive treatment for patients with cervical paragangliomas. Although, it may be difficult in patients with the advanced Shamblin types, in experienced hands, complication rates are very low.

Cited by 11 publications

References 24 publications

Perioperative blood pressure and heart rate alterations after carotid body tumor excision: a retrospective study of 108 cases

Perioperative blood pressure and heart rate alterations after carotid body tumor excision: a retrospective study of 108 cases

Simple and complex carotid paragangliomas. Three decades of experience and literature review

Postoperative Blood Pressure and Heart Rate Alterations After Carotid Body Tumor Excision: A Retrospective Study of 108 Cases

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