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Functional Adrenal Cortex Preservation: A Good Reason for Posterior Retroperitoneal Endoscopic Approach
- Source :
- Cirugía Española (English Edition). 96:488-493
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Introduction Cortical-sparing adrenalectomy is a suitable treatment for hereditary and sporadic bilateral pheochromocytoma, in cases of low risk of malignancy, to reduce the possibility of adrenal insufficiency assuming the chance of local recurrence. The aim of the study is to analyze the functional results of partial adrenalectomy by retroperitoneal endoscopic approach in single-adrenal patients or patients requiring bilateral adrenalectomy. Methods Prospective study between January 2015 and February 2016 including pheochromocytoma patients diagnosed with low risk of malignant mutations. All patients agreed to be included in the study. Experienced endocrine surgeons who have been trained in minimally invasive endocrine surgery performed the procedure using the same surgical technique. Demographic variables and clinical characteristics were collected, subsequently carrying out the descriptive analysis of the data. Results A total of 6 patients were registered, four associated with MEN type 2 syndrome and two in the context of VHL syndrome. Retroperitoneoscopic resection was performed without laparoscopic or open conversion and no postoperative complications; the average hospital stay was 2.5 days. Preservation of the functional cortex without corticosteroids was achieved in 5 (83%) of out 6 cases with a follow-up of 26.2±6 months. Today, these 5 patients have a preserved adrenal function without hormone replacement. Conclusions Cortical-sparing adrenalectomy by the retroperitoneal endoscopic approach, in expert hands, is safe and feasible for the treatment of hereditary and sporadic pheochromocytoma in a context of low malignancy, making it possible to avoid the need for corticoid replacement in most cases.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Adrenal Gland Neoplasm
Adrenal Gland Neoplasms
Context (language use)
Pheochromocytoma
030230 surgery
Malignancy
03 medical and health sciences
0302 clinical medicine
Adrenal insufficiency
medicine
Humans
Retroperitoneal space
Prospective Studies
Retroperitoneal Space
business.industry
Adrenalectomy
General Engineering
Endoscopy
Middle Aged
medicine.disease
Surgery
Endocrine surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
Adrenal Cortex
Female
business
Organ Sparing Treatments
Subjects
Details
- ISSN :
- 21735077
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- Cirugía Española (English Edition)
- Accession number :
- edsair.doi.dedup.....23fc94c2f950fdea84f343f00e0e242e