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A Ferriere1, V Kerlan2, A Tabarin1

  • 1Service d'endocrinologie, hôpital Haut-Lévèque, avenue Magellan, CHU de Bordeaux, 33600 Pessac, France.

Annales D'Endocrinologie
|November 22, 2017
PubMed
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Conservative adrenal surgery for endocrine tumors like pheochromocytomas and hyperaldosteronism preserves adrenal function. While effective, long-term monitoring is crucial due to potential recurrences.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Nephrology

Background:

  • Discussions at the 2017 Endocrine Society meeting focused on conservative adrenal surgery for specific conditions.
  • The primary goal is adrenal cortex preservation to avoid permanent adrenal insufficiency.

Purpose of the Study:

  • To review the outcomes and principles of conservative adrenal surgery for bilateral hereditary pheochromocytomas (BHP), bilateral adrenal macronodular hyperplasia (BAMH), and primary hyperaldosteronism (PHA).

Main Methods:

  • Review of communications and debates from the 2017 Endocrine Society annual meeting.
  • Analysis of surgical outcomes, recurrence rates, and long-term follow-up for BHP, BAMH, and PHA.

Main Results:

  • In BHP, cortical sparing surgery maintains normal corticotropic function in over 50% at 10 years, with ~10% recurrence.
Keywords:
Bilateral macronodular adrenal hyperplasiaBilateral pheochromocytomaChirurgie d’épargne surrénalienneConn adenomaCortical sparing surgeryHyperaldostéronisme primaire latéraliséHyperplasie macronodulaire bilatérale des surrénalesPhéochromocytomes bilatéraux

Related Experiment Videos

  • Unilateral adrenalectomy for BAMH normalizes cortisol in 92-100% but carries 13-60% late recurrence risk.
  • Minimally invasive surgery for lateralized PHA improves blood pressure in ~94% but has potential for failure or recurrence.

    • Conclusions:

    • Conservative adrenal surgery is a viable approach for BHP, BAMH, and PHA, aiming to preserve adrenal function.
    • Long-term patient monitoring is essential for all conditions due to the risk of recurrence.
    • While effective, the role of minimally invasive partial adrenal surgery for lateralized PHA remains limited.