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Adrenal-sparing surgery for a hormonally active tumour — a single-centre experience
Affiliations- Department of General and Endocrine Surgery, Medical University of Warsaw, Warsaw, Poland
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Abstract
Introduction: Surgeries that spare the adrenal cortex during adrenalectomy have profound justification. Indications for this type of surgery are fairly strict, and more than 30 years of observations continuously verify the results of the procedure.
Material and methods: Of a total of 650 adrenalectomies, 22 (3.4%) were adrenal cortex-sparing surgeries. There were 16 women and six men in this group. In 10 cases, surgery was performed for pheochromocytoma, eight cases involved Conn’s syndrome, and in four cases — paragangliomas located in the para-adrenal region. Secretory activity was identified in all cases.
Results: Laparoscopic partial adrenalectomy was performed in 20 patients. Conversion to open laparotomy was necessary in two cases. In patients after bilateral resection of pheochromocytoma surgery, glucocorticoids were supplemented for six weeks. No significant surgical complications were observed in this group.
Conclusions: Partial adrenalectomy for minor lesions should be a much more commonly utilised treatment method (of choice). Where bilateral adrenalectomy is necessary, a sparing procedure on one side protects patients from the need for hormonal substitution. The remaining part of the adrenal gland undertakes satisfactory secretory function after six weeks at the latest.
Abstract
Introduction: Surgeries that spare the adrenal cortex during adrenalectomy have profound justification. Indications for this type of surgery are fairly strict, and more than 30 years of observations continuously verify the results of the procedure.
Material and methods: Of a total of 650 adrenalectomies, 22 (3.4%) were adrenal cortex-sparing surgeries. There were 16 women and six men in this group. In 10 cases, surgery was performed for pheochromocytoma, eight cases involved Conn’s syndrome, and in four cases — paragangliomas located in the para-adrenal region. Secretory activity was identified in all cases.
Results: Laparoscopic partial adrenalectomy was performed in 20 patients. Conversion to open laparotomy was necessary in two cases. In patients after bilateral resection of pheochromocytoma surgery, glucocorticoids were supplemented for six weeks. No significant surgical complications were observed in this group.
Conclusions: Partial adrenalectomy for minor lesions should be a much more commonly utilised treatment method (of choice). Where bilateral adrenalectomy is necessary, a sparing procedure on one side protects patients from the need for hormonal substitution. The remaining part of the adrenal gland undertakes satisfactory secretory function after six weeks at the latest.
Keywords
adrenalectomy; partial adrenalectomy; sparing adrenalectomy
About this articleTitle
Adrenal-sparing surgery for a hormonally active tumour — a single-centre experience
Journal
Issue
Article type
Original paper
Pages
388-391
Published online
2020-05-29
Page views
825
Article views/downloads
573
DOI
10.5603/EP.a2020.0033
Pubmed
Bibliographic record
Endokrynol Pol 2020;71(5):388-391.
Keywords
adrenalectomy
partial adrenalectomy
sparing adrenalectomy
Authors
Sadegh Toutounchi
Ryszard Pogorzelski
Tomasz Wołoszko
Ewa Krajewska
Krzysztof Celejewski
Małgorzata Legocka
Wawrzyniec Jakuczun
Zbigniew Gałązka
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