Preview

Medical and Biological Problems of Life Activity

Advanced search

Adrenal insufficiency after surgical treatment of adrenal neoplasms: epidemiology, diagnosis, treatment and prevention

https://doi.org/10.58708/2074-2088.2024-1(31)-30-39

Abstract

The article provides an overview of the problem of postoperative adrenal insufficiency (AI) in patients after unilateral adrenalectomy. The clinical picture of AI and the consequences of untimely provision of medical care are described. The prevalence of the disease in various types of adrenal neoplasms after their surgical treatment is systematized and highlighted. Predictors of the AI development and modern laboratory methods for its diagnosis are presented. The issue of the current possibility of pharmacotherapy for this pathology has also been studied and highlighted. And more importantly, directions for the prevention of adrenal insufficiency in patients with adrenal neoplasms who are indicated for surgical treatment are described.

About the Authors

А. А. Chulkov
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus


Z. А. Dundarov
УО «Гомельский государственный медицинский университет»
Belarus


А. V. Velichko
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus


S. L. Zyblev
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus


Ya. L. Navmenova
ГУ «РНПЦ радиационной медицины и экологии человека»
Belarus


References

1. Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency / E.S. Husebye [et al.] // J Intern Med. – 2014. – Vol. 275, №2. – P. 104-115.

2. Pazderska, A. Adrenal insufficiency – recognition and management / A. Pazderska, S.H. Pearce // Clin Med (Lond). – 2017. – Vol. 17, №3. – P. 258-262.

3. Biryukova, E.V. Chronic adrenal insufficiency in clinical practice / E.V. Biryukova, E.S. Ganenkova, M.D. Lovanova // Consilium Medicum. – 2019. – Vol. 21, №4. – P. 103-108.

4. Clinical guidelines Diagnosis and treatment of primary adrenal insufficiency in adult: a Russian Association of Endocrinology Clinical Practice Guideline (project) / G.A. Mel'nichenko [et al.] // Consilium Medicum. – 2017. – Vol. 19, №4. – P. 8-19.

5. Primary adrenal insufficiency: diagnosis and management (According to the 17th European Congress of Endocrinology, Dublin, Ireland 16-20 May, 2015) / Yu.I. Komissarenko [et al.] // Mezhdunarodnyi ehndokrinologicheskii zhurnal. – 2015. – Vol. 7, №71. – P. 51-58.

6. Allolio, B. Extensive expertise in endocrinology. Adrenal crisis / B. Allolio // Eur J Endocrinol. – 2015. – Vol. 172, №3. – P. 115-124

7. Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies / S. Hahner [et al.] // Eur J Endocrinol. – 2010. – Vol. 162, №3. – P. 597-602.

8. Adrenal Crisis. / G. Elshimy [et al.] // In: StatPearls. Treasure Island (FL): StatPearls Publishing. – 2023.

9. Cooper, M.S. Corticosteroid insufficiency in acutely ill patients / M.S. Cooper, P.M. Stewart // N Engl J Med. – 2003. – Vol. 348, №8. – P. 727-734.

10. Unrecognized adrenal insufficiency in patients undergoing laparoscopic adrenalectomy / J. Mitchell [et al.] // Surg Endosc. – 2009. – Vol. 23, №2. – P. 248-254.

11. Biochemical assessment of adrenal insufficiency after adrenalectomy for non-cortisol secreting tumors: clinical correlation and recommendations / B. Kahramangil [et al.] // Surg Endosc. – 2022. – Vol. 36, №10. – P. 7638-7646.

12. Adrenal Insufficiency After Unilateral Adrenalectomy in Primary Aldosteronism: Long-Term Outcome and Clinical Impact / D.A. Heinrich [et al.] // J Clin Endocrinol Metab. – 2019. – Vol. 104, №11. – P. 5658-5664.

13. Outcomes of adrenal-sparing surgery or total adrenalectomy in phaeochromocytoma associated with multiple endocrine neoplasia type 2: an international retrospective population-based study / F. Castinetti [et al.] // Lancet Oncol. – 2014. – Vol. 15, №6. – P. 648-655.

14. Adrenal function after adrenalectomy for subclinical hypercortisolism and Cushing's syndrome: a systematic review of the literature / G. Di Dalmazi [et al.] // J Clin Endocrinol Metab. – 2014. – Vol. 99, №8. – P. 2637-2645.

15. Outcome of adrenalectomy for subclinical hypercortisolism and Cushing syndrome / M. Raffaelli [et al.] // Surgery. – 2017. – Vol. 161, №1, P. 264-271.

16. Yokoyama, H. Incidence of adrenal involvement and assessing adrenal function in patients with renal cell carcinoma: is ipsilateral adrenalectomy indispensable during radical nephrectomy? / H. Yokoyama, M. Tanaka // BJU Int. – 2005. – Vol. 95, №4. – P. 526-529.

17. Chronic primary adrenal insufficiency after unilateral adrenonephrectomy: A case report / S. Yoshiji [et al.] // Medicine (Baltimore). – 2017. – Vol. 96, №51. – P. 90-91.

18. Reduced adrenal secretory mass after unilateral adrenalectomy for aldosterone-producing adenoma may explain unexpected incidence of hypotension / R.D. Gordon [et al.] // J Hypertens Suppl. – 1989. – Vol. 7, №6. – P. 210-211.

19. Adrenal reserve function after unilateral adrenalectomy in patients with primary aldosteronism / K. Honda [et al.] // J Hypertens. – 2013. – Vol. 31, №10. – P. 2010-2017.

20. Kim, H.J. Unusual skin pigmentation after unilateral adrenalectomy due to pheochromocytoma: a case report / H.J. Kim, S.H. Lee // Gland Surg. – 2023. – Vol. 12, №6. – P.860-866.

21. Predictability of hypoadrenalism occurrence and duration after adrenalectomy for ACTH-independent hypercortisolism / V. Morelli [et al.] // J Endocrinol Invest. – 2018. – Vol. 41, №4. – P. 485-493.

22. Extensive clinical experience: Hypothalamic-pituitary-adrenal axis recovery after adrenalectomy for corticotropin-independent cortisol excess / M.D. Hurtado [et al.] // Clin Endocrinol (Oxf). – 2018. – Vol. 89, №6. – P. 721-733.

23. Post-surgical hypocortisolism after removal of an adrenal incidentaloma: is it predictable by an accurate endocrinological work-up before surgery? / C. Eller-Vainicher [et al.] // Eur J Endocrinol. – 2010. – Vol. 162, №1. – P. 91-99.

24. Preclinical Cushing's syndrome in adrenal «incidentalomas»: comparison with adrenal Cushing's syndrome / M. Reincke [et al.] // J Clin Endocrinol Metab. – 1992. – Vol. 75, №3. – P. 826-832.

25. Contralateral adrenal width predicts the duration of prolonged post-surgical steroid replacement for subclinical Cushing syndrome / M. Sugiura [et al.] // Int J Urol. – 2018. – Vol. 25, №6. – P. 583-588.

26. Factors predicting prolonged glucocorticoid therapy in patients with adrenal insufficiency after laparoscopic adrenalectomy / F. Ziglioli [et al.] // Ann Med Surg (Lond). – 2022. – Vol. 77.

27. The natural history of adrenal function in autoimmune patients with adrenal autoantibodies / C. Betterle [et al.] // J Endocrinol. – 1988. – Vol. 117, №3. – P. 467-475.

28. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline / S.R. Bornstein [et al.] // J Clin Endocrinol Metab. – 2016. – Vol. 101, №2. – P. 364-389.

29. Haplotype analysis discriminates genetic risk for DR3-associated endocrine autoimmunity and helps define extreme risk for Addison's disease / P.R. Baker [et al.] // J Clin Endocrinol Metab. – 2010. – Vol. 95, №10. – P. 263-270.

30. Cortisol: ACTH ratio to test for primary hypoadrenalism: a pilot study / M.K. Lee [et al.] // Postgrad Med J. – 2013. – Vol. 89, №1057. – P. 617-620.

31. Arlt, W. Adrenal insufficiency / W. Arlt, B.Allolio // Lancet. – 2003. – Vol. 361, №9372. – P. 1881-1893.

32. Dedov, I.I. Endokrinologiia. / I.I. Dedov, G.A. Mel'nichenko, V.V. Fadeev. – 3-e izd., pererab. i dop. – M.: Litterra, 2015.

33. Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients / I.L. Ross [et al.] // PloS one. – 2014. – Vol. 9, №6.

34. Posterior retroperitoneoscopy as a new minimally invasive approach for adrenalectomy: results of 30 adrenalectomies in 27 patients. / M.K. Walz [et al.] // World J Surg. – 1996. – Vol. 20, №7. – P. 769-774.

35. Nagaraja, V. Recurrence and functional outcomes of partial adrenalectomy: a systematic review and meta-analysis / V. Nagaraja, G.D. Eslick, S. Edirimanne // Int J Surg. – 2015. – Vol. 16, Pt. A. – P. 7-13.

36. Surgical management of large adrenal tumors: impact of different laparoscopic approaches and resection methods on perioperative and long-term outcomes / W. Chen [et al.] // BMC Urol. – 2018. – Vol. 18, №1. – P. 31.

37. Laparoscopic Partial Adrenalectomy: Surgical Technique and Outcome / O.S. Ko [et al.] // Korean J Urol Oncol. – 2019. – Vol.17, №2. – P.103-109.

38. Retroperitoneoscopic enucleation adrenalectomy: a viable surgical option for small nonsecreting adrenal tumors with low potential of malignancy / H. Yan [et al.] // Transl Androl Urol. – 2023. – Vol. 12, №11. – P. 1713-1722.


Supplementary files

Review

For citations:


Chulkov А.А., Dundarov Z.А., Velichko А.V., Zyblev S.L., Navmenova Ya.L. Adrenal insufficiency after surgical treatment of adrenal neoplasms: epidemiology, diagnosis, treatment and prevention. Medical and Biological Problems of Life Activity. 2024;(1):30-39. (In Russ.) https://doi.org/10.58708/2074-2088.2024-1(31)-30-39

Views: 117


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2088 (Print)