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Khirurgii

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Year 2019 Vol. 27 No 1

ONCOLOGY

L.P. KOTELNIKOVA 1, A.N. FEDACHUK 2

ASSESSMENT OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ADRENAL TUMORS DURING SKIN THERMOMETRY WITH LOCAL HEATING

Perm State Medical University named after E.A. Wagner 1,
Perm Regional Clinical Hospital 2, Perm,
The Russian Federation

Objective. To investigate the endothelial dysfunction in patients with adrenal tumors during skin thermometry before and after surgery.
Methods. «Microtest», a device for skin thermometry, was used to detect endothelial dysfunction in 19 patients with the adrenal tumors. The index of thermal vasodilation K was calculated for the endothelial, neurogenic and myogenic ranges. The patients were divided into two groups: patients with pheochromocytoma (n=8) and with hormonal inactive adrenal tumors and arterial hypertension (n=11). The comparison group consisted of 27 healthy adults.
Results. The patients with pheochromocytoma had lower thermal vasodilatation indices in all ranges in comparison to healthy adults; this difference was significant only in the myogenic and neurogenic ranges. A significant decrease of all indices of thermal vasodilation for patients of the second group was observed. A significant increase in indices of thermal vasodilatation in the endothelial and myogenic ranges was registered in patients with pheochromocytoma as well as the trend to rise in the neurogenic range during the early postoperative period. There was a strong positive association between the normalization of blood pressure in the postoperative period, the preoperative treatment with doxazosin, and the value of the index of thermal vasodilation in the endothelial range after the surgery.
Conclusions. All patients with pheochromocytomas, hormone-inactive adrenal tumors and arterial hypertension had the signs of impaired microvascular bed endothelial function. Preoperative treatment and adrenalectomy significantly improve the reaction of the microvascular endothelium in response to external heat stimuli in patients with pheochromocytoma.

Keywords: endothelial dysfunction, skin thermometry with local heating, adrenal tumors, pheochromocytoma, preoperative treatment
p. 66-71 of the original issue
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Address for correspondence:
614000, The Russian Federation,
Perm, Pushkin Str., 85,
Perm Regional Clinical Hospital,
1st Surgical Unit.
Tel. +79024747460,
e-mail: 89024747460@mail.ru,
Alexey N. Fedachuk
Information about the authors:
Kotelnikova Liudmila P., MD, Professor, Head of the Surgery Department of the Postgraduate Additional Education, Perm State Medical University named after E.A. Wagner, Russian Federation.
https://orcid.org/0000-0002-8602-1405
Fedachuk Alexey N., Clinical Intern of the 1st Surgical Unit, Perm Regional Clinical Hospital, Perm, Russian Federation.
https://orcid.org/0000-0001-5756-8981
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