양측 부신 절제술의 수술 후 결과 분석

강보라; 김지영; 최준호; 김지수; 남석진; 양정현; 김정한

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자료유형: 학술저널

저자정보: 강보라 김지영 최준호 김지수 남석진 양정현 김정한

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제13권 제4호

발행연도: 2013.1

수록면: 234 - 238 (5page)

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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.

#양측 부신 절제술 #부신 전절제술 #부신 부분절제술 #Bilateral adrenalectomy #Total adrenalectomy #Partial adrenalectomy

참고문헌 (11)

참고문헌 신청

Brauckhoff M / 2003 / Critical size of residual adrenal tissue and recovery from impaired early postoperative adrenocortical function after subtotal bilateral adrenalectomy /

Brauckhoff M / 2003 / Subtotal bilateral adrenalectomy preserving adrenocortical function / Chirurg 74 : 646 ~ 651

Brunt LM / 2002 / Adrenalectomy for familial pheochromocytoma in the laparoscopic era / Ann Surg 235 : 713 ~ 720

Diner EK / 2005 / Partial adrenalectomy: the National Cancer Institute experience / Urology 66 : 19 ~ 23

Edis AJ / 1984 / Surgery of the adrenals, Manual of endocrine surgery / Springer-Verlag : 151 ~ 242