Organ preserving operations in the treatment of benign tumors of the adrenal glands

Authors

  • О.B. Kutovoy State Institution “Dnipropetrovsk Medical Academy of Ministry of Health of Ukraine”, Dnipro, Ukraine
  • E.V. Zhmurenko State Institution “Dnipropetrovsk Medical Academy of Ministry of Health of Ukraine”, Dnipro, Ukraine

DOI:

https://doi.org/10.22141/1997-2938.4.35.2017.118892

Keywords:

subtotal adrenalectomy, adrenal tumor, hand assisted adrenalectomy

Abstract

Background. Modern methods of visualization make it possible to reveal the formations in the adrenal gland in 98.4 % of cases. The most common method of treatment of adrenal tumors is endovideosurgical adrenalectomy. However, in cases of peripheral localization of the tumor, hypoplasia of the unaffected gland, the presence of hormonal formation with suppression of the cortex of the contralateral adrenal gland, it is expedient to maintain the organ preserving surgeries, such as subtotal adrenalectomy. Implementation of the latter has a number of advantages. The purpose of the study was to evaluate the results of organ preserving operations with unilateral benign adrenocortical tumors. Materials and methods. From 2011 to 2016, in the MI “I.I. Mechnikov Regional Clinical Hospital”, 97 patients with benign adrenal gland tumors were examined and operated. Of these, hand assisted laparoscopic interventions were performed in 80 patients, who were divided into 2 groups: main — 42 individuals after subtotal resection, control — 38 persons after total adrenalectomy. Results. The results obtained after subtotal adrenalectomy favorably differed on the majority of parameters as compared with the total ones, characterizing not only the course of the surgery, but also the incidence of postoperative complications. Conclusions. Hand assisted laparoscopic subtotal adrenalectomy is an effective method of surgical treatment of unilateral peripheral benign tumors of the adrenal glands. The most frequent pathomorphological type of neoplasms is an adenoma, the detection rate of which was 61.3 %. Recurrences of tumors after subtotal resections and total adrenalectomies with a follow-up period of 2 to 36 months were not revealed.

References

Лапароскопическая резекция надпочечников / С.И. Емельянов, И.А. Курганов, Д.Ю. Богданов, Н.Л. Матвеев // Эндоскоп. хирургия. — 2010. — Т. 16, № 3. — С. 11-17.

Лапароскопическая резекция надпочечника / М.Е. Ничитайло, В.В. Черный, О.Н. Гулько [и др.] // Укр. журн. хирургии. — 2013. — № 4. — С. 48-51.

Отдаленные результаты хирургического лечения инциденталом надпочечников / М.Е. Белощицкий, А.П. Калинин, О.П. Богатырев [и др.] // Практическая медицина. — 2012. — № 9. — С. 21-25.

Семенов Д.Ю. Сравнительная оценка различных объемов операций при опухолевых заболеваниях надпочечников / Д.Ю. Семенов, П.А. Панкова, З.Х. Османов // Эндокрин. хирургия. — 2016. — Т. 10, № 2. — С. 52-59.

Чаусова В.Г. Оценка отдаленных результатов радикальных и органосохраняющих операций при опухолях надпочечников / В.Г. Чаусова, П.А. Панкова, Э.А. Рамазанова // Ученые записки СПбГМУ им. акад И.П. Павлова. — 2014. — Т. 21, № 2. — С. 36-39.

Laparoscopic resection is safe and feasible for large

(≥ 6 cm) pheochromocytomas without suspicion of malignancy / M. Yvette, M.D. Carter, M.D. Haggi Mazeh [et al.] // Endocrin. Pract. — 2012. — Vol. 18, № 5. — Р. 720-726.

Perioperative, functional, and oncologic outcomes of partial adrenalectomy for multiple ipsilateral pheochromocytomas / G.N. Gupta, J.S. Benson, M.J. Ross [et al.] // J. Endourol. — 2014. — Vol. 28, № 1. — Р. 112-116.

Retroperitoneal adrenalsparing surgery for the treatment of Cushing’s syndrome caused by adrenocortical adenoma: 8 year experience with 87 patients / H.C. He [et al.] // World J. Surg. — 2012. — Vol. 36, № 5. — P. 182-188.

Toniato A. Minimally invasive surgery for malignant adrenal tumors / А. Toniato // Surgeon. — 2013, Feb 13 [Epub ahead of print].

Issue

Section

Original Researches