Organ preserving operations in the treatment of benign tumors of the adrenal glands
Keywords:subtotal adrenalectomy, adrenal tumor, hand assisted adrenalectomy
AbstractBackground. 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.
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