Surgical Outcomes of Bilateral Adrenalectomy.
10.16956/kjes.2013.13.4.234
- Author:
Bo Ra KANG
1
;
Jiyoung KIM
;
Jun Ho CHOE
;
Jee Soo KIM
;
Seok Jin NAM
;
Jung Hyun YANG
;
Jung Han KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jinnee.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Bilateral adrenalectomy;
Total adrenalectomy;
Partial adrenalectomy
- MeSH:
Adrenal Glands;
Adrenal Insufficiency;
Adrenalectomy*;
Cushing Syndrome;
Follow-Up Studies;
Humans;
Hyperaldosteronism;
Pheochromocytoma;
Recurrence;
Retrospective Studies
- From:Korean Journal of Endocrine Surgery
2013;13(4):234-238
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Because the main drawback of bilateral adrenalectomy is permanent adrenal insufficiency and the subsequent risks of life-long steroid use, adrenal preserving partial adrenalectomy is being accepted as its alternative. The aim of this study is to investigate the indications for bilateral adrenalectomy and to assess the postoperative outcomes and steroid replacement according to operative methods. METHODS: From May 1996 through July 2013, a total of 25 patients who underwent bilateral adrenalectomy in our institution were reviewed retrospectively. Surgical outcomes were compared between total and partial adrenalectomy, and postoperative steroid hormone replacement were examined according to the volume of remnant adrenal gland. RESULTS: The median follow-up duration of 25 patients was 55.8 months. The most common indication for bilateral adrenalectomy was bilateral pheochromocytoma (n=16), which was associated with genetic mutation of RET or VHL gene in 11 cases. Cushing's syndrome (n=8) and hyperaldosteronism (n=1) were another indications of bilateral adrenalectomy. Total adrenalectomy was performed in 8 patients and adrenal preserving partial adrenalectomy in 17 patients. Among the 17 patients, only 5 patients needed adrenal hormone replacement and 2 patients had a recurrence at remnant adrenal tissue. CONCLUSION: Adrenal preserving partial adrenalectomy might be a better option for bilateral adrenal tumor than total adrenalectomy because it can reduce complications associated with adrenal insufficiency and recurrence of the disease is not common.
