Adrenal-sparing surgery: current concepts on a theme from the past
| Autor: | Gr Kaltsas, George N Zografos, Ch Aggeli, Iraklis Perysinakis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Endocrinology Diabetes and Metabolism Partial adrenalectomy Adrenal Gland Neoplasms 030209 endocrinology & metabolism Adrenalectomy General Medicine 030204 cardiovascular system & hematology Controlled studies medicine.disease Surgery Review article Pheochromocytoma 03 medical and health sciences 0302 clinical medicine Adrenal masses medicine Adrenal insufficiency Endocrine system Humans business Tumor Identification Adrenal Insufficiency |
| Zdroj: | Hormones (Athens, Greece). 19(3) |
| ISSN: | 2520-8721 |
| Popis: | Adrenal insufficiency represents a debilitating condition which mandates lifelong steroid replacement and which is associated with significant long-term morbidity, due to either inadequate or excessive replacement. The concept of preserving healthy cortical tissue by means of partial adrenalectomy has evolved as a means of avoiding the detrimental consequences of adrenal insufficiency. The advent of advanced technology in adrenal surgery has greatly facilitated the performance of partial adrenalectomy, enabling utilization of this method in an increasing number of endocrine diseases. Hereditary pheochromocytoma, Conn's syndrome, Cushing's syndrome, and non-functional adrenal masses represent the current indications for partial adrenalectomy, although the specific circumstances under which adrenal-sparing surgery should be proposed are still debatable. Partial adrenalectomy can be achieved by all types of minimally invasive surgery. In the absence of randomized, prospective, controlled studies designed to compare laparoscopic, retroperitoneoscopic, and robot-assisted partial adrenalectomy, none of these techniques has as yet been proven to be the gold standard for adrenal-sparing surgery. Apart from indications for surgery, results of surgery, and different types of partial adrenalectomy, controversial topics addressed in this review article include technical aspects such as the volume of residual adrenal tissue needed, ligation of adrenal vein, and means of tumor identification. Discussion of these controversial topics represents an attempt to define the role of partial adrenalectomy in modern adrenal surgery. |
| Databáze: | OpenAIRE |
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