title: [Function-preserving adrenalectomy for adrenal tumors].
abstract: Organ preserving resection (subtotal adrenalectomy) or adrenocortical autotransplantation can preserve adrenocortical stress capacity in bilateral adrenal surgery. After adrenocortical autotransplantation approximately 30% of patients do not need exogenous steroids. Organ preserving surgery avoids steroid supplementation in more than 80% of cases. After organ preserving resections in secondary or familial diseases, however, there is a relevant risk of recurrent disease: the rate of ipsilateral recurrence in familial pheochromocytoma is approximately 20% during a follow-up of 20 years. Routine administration of exogenous steroids should be avoided after subtotal adrenalectomy as functional restitution of the residual tissue might be disturbed. Approximately 80% of patients, however, present with impaired adrenocortical stress capacity directly after surgery. Within a few weeks some 80% of patients show a sufficient functional restitution of the adrenocortical stress capacity. Organ preserving adrenal surgery should be performed endoscopically. The adrenal remnant should not be devascularized; the adrenal vein, however, can be divided without functional consequences. About one third of a normal adrenal gland usually provides sufficient adrenocortical function.
authors.affiliation: Department of Surgical Sciences, University of Bergen, Jonas Lies vei 65, 5021, Bergen, Norway. michael.brauckhoff@helse-bergen.no
authors.forename: M
authors.initials: M
authors.lastname: Brauckhoff
authors.forename: H
authors.initials: H
authors.lastname: Dralle
mesh_terms: D000302:Adrenal Cortex / Q000503:physiopathology / Q000637:transplantation*; D000310:Adrenal Gland Neoplasms / Q000235:genetics / Q000503:physiopathology / Q000601:surgery*; D000309:Adrenal Insufficiency / Q000503:physiopathology / Q000517:prevention & control; D000315:Adrenalectomy / Q000379:methods*; D000818:Animals; D004195:Disease Models, Animal; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000517:prevention & control; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000503:physiopathology / Q000601:surgery; D059351:Organ Sparing Treatments / Q000379:methods*; D010673:Pheochromocytoma / Q000235:genetics / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D006854:Hydrocortisone