Technical aspects of subtotal endoscopic adrenalectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2003-03

AUTHORS

M. Brauckhoff, K. Kaczirek, P. N. Thanh, O. Gimm, Katrin Brauckhoff, Annett Bär, B. Niederle, H. Dralle

ABSTRACT

Background: The frequency of subtotal adrenalectomy has increased since the introduction of endoscopic approaches. In this study, we examined technical aspects of endoscopic subtotal adrenalectomy with respect to postoperative adrenocortical function.Methods: Sixteen patients with endoscopic subtotal adrenalectomy were included in this study (10 inherited phaeochromocytomas, five adrenocortical tumours, and one bilateral adrenocortical hyperplasia). Unilateral tumours were found in 10 patients, and bilateral tumours were found in five patients. The five patients with bilateral tumours underwent unilateral subtotal adrenalectomy following contralateral total adrenalectomy. In these patients, the main adrenal vein was divided. Fifteen operations were performed laparoscopically. In one patient, the retroperitoneoscopic approach was used. In patients with bilateral operations, an ACTH test was performed postoperatively.Results: More than one-third of one adrenal gland was left in situ in four patients. In eight patients, an adrenal remnant of about one-third of an adrenal gland was preserved. In the remaining four patients, the adrenal remnant was smaller than one-third. There were no complications. During a mean follow-up of 27 months, no recurrence was observed. Four of the five patients with bilateral tumours had an intact ACTH test. Neither patient with bilateral operations required steroids. In all five patients, the adrenal remnant was about one-third of an adrenal gland.Conclusions: Endoscopic subtotal adrenalectomy has a similar success rate to the open approach. As regards recurrent adrenal tumours and influencing factors, no conclusions can be drawn due to the short follow-up. One-third of an adrenal gland on one side is enough for sufficient adrenocortical function even after division of the main vein. The impact of subtotal adrenalectomy in patients with unilateral tumours has to be exmained in future studies. More... »

PAGES

84-88

Identifiers

URI

http://scigraph.springernature.com/pub.10.1046/j.1682-4016.2003.03052.x

DOI

http://dx.doi.org/10.1046/j.1682-4016.2003.03052.x

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https://app.dimensions.ai/details/publication/pub.1028581219


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