Skuteczność jednostronnej adrenalektomii laparoskopowej w hiperkortyzolemii i subklinicznym zespole Cushinga niezależnych od ACTH — badanie retrospektywne na dużej kohorcie

Pogorzelski, Ryszard; Toutounchi, Sadegh; Ambroziak, Urszula; Krajewska, Ewa; Wołoszko, Tomasz; M, Szostek; Jakuczun, Wawrzyniec; Celejewski, Krzysztof; Legocka, Małgorzata; Kwasiborski, Przemysław; Gałązka, Zbigniew; Biskup, Ewelina

doi:10.5603/ep.a2018.0039

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…We reserve the possibility of sparing adrenalectomy for the opposite adrenal gland. Analysis of our clinical material from patients with this type of pathology has confirmed the legitimacy of such management [11]. In our experience, the greatest problems with sparing adrenalectomy may be associated with pheochromocytoma, especially of cases of larger cortical tumours.…”

Section: Discussionsupporting

confidence: 56%

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

Toutounchi

Pogorzelski

Wołoszko

et al. 2020

Endokrynologia Polska

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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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Section: Discussionsupporting

confidence: 56%

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

Toutounchi

Pogorzelski

Wołoszko

et al. 2020

Endokrynologia Polska

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“…The excision of the tumour with complete removal of the surrounding adrenal tissue is the standard method of management in the case of unilateral tumours. Currently, in the case of benign adrenal lesions, laparoscopic techniques are widely accepted, ensuring safe and effective treatment [7,8]. Laparoscopic adrenalectomy Agnieszka Kotecka-Blicharz, Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, tel: (+48) 322 789 932; e-mail: Agnieszka.Kotecka-Blicharz@io.gliwice.pl  ORIGINAL PAPER of patients, tumours in the contralateral adrenal gland may appear.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic cortical-sparing adrenal surgery in pheochromocytomas associated with hereditary neoplasia syndromes

Hasse-Lazar

Zeman

Kotecka-Blicharz

et al. 2020

Endokrynologia Polska

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Introduction: Pheochromocytomas in hereditary syndromes tend to grow multifocal with adrenal involvement on both sides. Surgical treatment with bilateral adrenalectomy inevitably leads to life-long hormonal dependence, which significantly affects quality of life. The development of minimally invasive adrenal surgery has created a chance to preserve adrenal cortex function in these patients. The aim of the present study was to evaluate the safety of laparoscopic cortical-sparing adrenal surgeries and their efficacy in the prevention of postoperative adrenal insufficiency in patients with hereditary pheochromocytomas. Material and methods: We retrospectively analysed the medical histories of 10 patients, who underwent 10 laparoscopic cortical sparing adrenal surgeries from January 2015 to January 2019 in our centre. The decision to perform sparing surgery was based on preoperative diagnosis of hereditary syndrome in line with the result of DNA analysis or its diagnosis based on the clinical appearance. All surgeries were performed laparoscopically from transperitoneal access in the lateral decubitus position, with preserving 1/3-1/4 adrenal tissue. The sufficiency of remnant adrenal tissue was assessed in all patients. The median time of follow-up was three years (ranged 0.5-4 years). Results: No intraoperative complications were observed. One case of acute heart failure was the only early postoperative adverse event. There were no late postoperative complications and no local recurrences observed. In one out of three patients undergoing sparing surgery as a second procedure after former total adrenalectomy, adrenal cortex failure occurred. In all patients after unilateral surgery or after bilateral surgery performed simultaneously (total adrenalectomy at one side and sparing surgery contralaterally), function of remnant adrenal tissue was preserved. Conclusions: In hereditary pheochromocytomas, with minimal risk of malignant process, laparoscopic cortical sparing adrenal surgeries are the safe approach and provide the chance to preserve adrenal cortex function.

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Skuteczność jednostronnej adrenalektomii laparoskopowej w hiperkortyzolemii i subklinicznym zespole Cushinga niezależnych od ACTH — badanie retrospektywne na dużej kohorcie

Abstract: Transperitoneal unilateral laparoscopic adrenalectomy is an efficient and safe treatment option in patients with ACTH- -independent hypercortisolaemia, both overt and subclinical.

Cited by 2 publications

References 12 publications

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

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

Laparoscopic cortical-sparing adrenal surgery in pheochromocytomas associated with hereditary neoplasia syndromes

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