Related Experiment Video
Updated: Jul 4, 2026
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
[Indications for conventional adrenalectomy]
I Gockel1, A Heintz, M Domeyer
1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität Mainz. gockel@ach.klinik.uni-mainz.de
Zentralblatt Fur Chirurgie
|June 20, 2008
Summary
Conventional adrenalectomy remains crucial for larger tumors like adrenocortical carcinomas and adrenal metastases. Minimally invasive surgery is preferred for conditions such as Cushing's disease and pheochromocytoma.
Area of Science:
- Endocrine Surgery
- Surgical Oncology
Background:
- Conventional adrenalectomy is still relevant despite advances in minimally invasive endocrine surgery.
- This study analyzes indications for conventional adrenalectomy since the introduction of laparoscopic and retroperitoneoscopic techniques in 1994.
Purpose of the Study:
- To compare the indications and outcomes of conventional versus minimally invasive adrenalectomy.
- To determine the continued role of conventional adrenalectomy in current surgical practice.
Main Methods:
- A retrospective analysis of 412 adrenalectomies performed between January 1994 and September 2006.
- Patients were divided into conventional (106 operations) and endoscopic (306 operations) groups.
Main Results:
- Conventional adrenalectomy was more frequently indicated for adrenocortical carcinomas (ACC) and adrenal metastases, especially with multivisceral resections.
- Minimally invasive adrenalectomy was preferred for adrenal Cushing's disease, pheochromocytoma, incidentaloma, and Conn's syndrome.
- Tumors removed conventionally were significantly larger (mean 6.0 cm) than those removed endoscopically (mean 3.3 cm).
Conclusions:
- Conventional adrenalectomy was performed in 26% of cases since 1994, highlighting its ongoing importance.
- The utility of laparoscopic procedures for malignant pheochromocytoma, ACC, and localized adrenal metastases requires further investigation through prospective studies.
Related Concept Videos
01:27Adrenal Gland Disorders
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
01:26Cushing Syndrome I: Introduction
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
01:30Adrenergic Agonists: Therapeutic Uses
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
01:17Anatomy of the Adrenal Glands
The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct regions...
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct regions...
01:19Cushing Syndrome II: Pathophysiology
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
01:31Hormones of the Adrenal Glands
Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and corticosterone...
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and corticosterone...