open access

Vol 71, No 5 (2020)
Original paper
Submitted: 2020-04-06
Accepted: 2020-05-06
Published online: 2020-05-29
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Adrenal-sparing surgery for a hormonally active tumour — a single-centre experience

Sadegh Toutounchi1, Ryszard Pogorzelski1, Tomasz Wołoszko1, Ewa Krajewska1, Krzysztof Celejewski1, Małgorzata Legocka1, Wawrzyniec Jakuczun1, Zbigniew Gałązka1
·
Pubmed: 33140380
·
Endokrynol Pol 2020;71(5):388-391.
Affiliations
  1. Department of General and Endocrine Surgery, Medical University of Warsaw, Warsaw, Poland

open access

Vol 71, No 5 (2020)
Original Paper
Submitted: 2020-04-06
Accepted: 2020-05-06
Published online: 2020-05-29

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. 

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Keywords

adrenalectomy; partial adrenalectomy; sparing adrenalectomy

About this article
Title

Adrenal-sparing surgery for a hormonally active tumour — a single-centre experience

Journal

Endokrynologia Polska

Issue

Vol 71, No 5 (2020)

Article type

Original paper

Pages

388-391

Published online

2020-05-29

Page views

972

Article views/downloads

690

DOI

10.5603/EP.a2020.0033

Pubmed

33140380

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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