Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 4/2019

01.04.2019 | Systematic Reviews and Meta-analysis

Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK)

verfasst von: K. Lorenz, P. Langer, B. Niederle, P. Alesina, K. Holzer, Ch. Nies, Th. Musholt, P. E. Goretzki, N. Rayes, M. Quinkler, J. Waldmann, D. Simon, A. Trupka, R. Ladurner, K. Hallfeldt, A. Zielke, D. Saeger, Th. Pöppel, G. Kukuk, A. Hötker, P. Schabram, S. Schopf, C. Dotzenrath, P. Riss, Th. Steinmüller, I. Kopp, C. Vorländer, M. K. Walz, D. K. Bartsch

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Background and aims

Previous guidelines addressing surgery of adrenal tumors required actualization in adaption of developments in the area. The present guideline aims to provide practical and qualified recommendations on an evidence-based level reviewing the prevalent literature for the surgical therapy of adrenal tumors referring to patients of all age groups in operative medicine who require adrenal surgery. It primarily addresses general and visceral surgeons but offers information for all medical doctors related to conservative, ambulatory or inpatient care, rehabilitation, and general practice as well as pediatrics. It extends to interested patients to improve the knowledge and participation in the decision-making process regarding indications and methods of management of adrenal tumors. Furthermore, it provides effective medical options for the surgical treatment of adrenal lesions and balances positive and negative effects. Specific clinical questions addressed refer to indication, diagnostic procedures, effective therapeutic alternatives to surgery, type and extent of surgery, and postoperative management and follow-up regime.

Methods

A PubMed research using specific key words identified literature to be considered and was evaluated for evidence previous to a formal Delphi decision process that finalized consented recommendations in a multidisciplinary setting.

Results

Overall, 12 general and 52 specific recommendations regarding surgery for adrenal tumors were generated and complementary comments provided.

Conclusion

Effective and balanced medical options for the surgical treatment of adrenal tumors are provided on evidence-base. Specific clinical questions regarding indication, diagnostic procedures, alternatives to and type as well as extent of surgery for adrenal tumors including postoperative management are addressed.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
2.
Hartel W, Röher HD, Simon D, Frilling A, Rothmund M, Wagner PK, Klempa I, Goretzki PE, Becker HD, Niederle B, Nies C, Wahl RA, Dralle H (2000) Deutsche Gesellschaft für Chirurgie, Leitlinien zur chirurgischen Therapie von Nebennierenerkrankungen. Mitteilung der Deutschen Gesellschaft für Chirurgie 4:G92
3.
Palazzo FF, Sebag F, Sierra M, Ippolito G, Souteyrand P, Henry JF (2006) Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors. World J Surg 30:893–898CrossRefPubMed
4.
Walz MK, Petersenn S, Koch JA, Mann K, Neumann HP, Schmid KW (2005) Endoscopic treatment of large primary adrenal tumours. Br J Surg 92:719–723CrossRefPubMed
5.
Tischler AS (2008) Pheochromocytoma and extra-adrenal paraganglioma: updates. Arch Pathol Lab Med 132:1272–1284PubMed
6.
Walz MK (2012) Minimally invasive adrenal gland surgery. Transperitoneal or retroperitoneal approach? Chirurg 83:536–545CrossRefPubMed
7.
Asari R, Koperek O, Niederle B (2012) Endoscopic adrenalectomy in large adrenal tumors. Surgery 152:41–49CrossRefPubMed
8.
Gaujoux S, Mihai R (2017) European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma. Joint working group of ESES and ENSAT. Br J Surg 104:358–376CrossRefPubMed
9.
Boland GW, Lee MJ, Gazelle GS, Halpern EF, McNicholas MM, Mueller PR (1998) Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Am J Roentgenol 171:201–204CrossRef
10.
Israel GM, Korobkin M, Wang C, Hecht EN, Krinsky GA (2004) Comparison of unenhanced CT and chemical shift MRI in evaluating lipid-rich adrenal adenomas. AJR Am J Roentgenol 183:215–219CrossRefPubMed
11.
Brix D, Allolio B, Fenske W, Agha A, Dralle H, Jurowich C, Langer P, Mussack T, Nies C, Riedmiller H, Spahn M, Weismann D, Hahner S, Fassnacht M, German Adrenocortical Carcinoma Registry Group (2010) Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 58:609–615CrossRef
12.
Lombardi CP, Raffaelli M, De Crea C, Boniardi M, De Toma G, Marzano LA, Miccoli P, Minni F, Morino M, Pelizzo MR, Pietrabissa A, Renda A, Valeri A, Bellantone R (2012) Open versus endoscopic adrenalectomy in the treatment of localized (stage I/II) adrenocortical carcinoma: results of a multiinstitutional Italian survey. Surgery 152:1158–1164CrossRefPubMed
13.
Brauckhoff M, Gimm O, Thanh PN, Bär A, Ukkat J, Brauckhoff K, Bönsch T, Dralle H (2003) Critical size of residual adrenal tissue and recovery from impaired early postoperative adrenocortical function after subtotal bilateral adrenalectomy. Surgery 134:1020–1028CrossRefPubMed
14.
Alesina PF, Hinrichs J, Meier B, Schmid KW, Neumann HP, Walz MK (2012) Minimally invasive cortical-sparing surgery for bilateral pheochromocytomas. Langenbeck's Arch Surg 397:233–238CrossRef
15.
Walz MK (2009) Adrenalectomy for preservation of adrenocortical function. Indication and results. Chirurg 80:99–104CrossRefPubMed
16.
Alesina PF, Hommeltenberg S, Meier B, Petersenn S, Lahner H, Schmid KW, Mann K, Walz MK (2010) Posterior retroperitoneoscopic adrenalectomy for clinical and subclinical Cushing’s syndrome. World J Surg 34:1391–1397CrossRefPubMed
17.
Telenius-Berg M, Ponder MA, Berg B, Ponder BA, Werner S (1989) Quality of life after bilateral adrenalectomy in MEN 2. Henry Ford Hosp Med J 37:160–163
18.
Lairmore TC, Ball DW, Baylin SB, Wells SA Jr (1993) Management of pheochromocytomas in patients with multiple endocrine neoplasia type 2 syndromes. Ann Surg 217:595–601CrossRefPubMedPubMedCentral
19.
Erlic Z, Rybicki L, Peczkowska M, Golcher H, Kann PH, Brauckhoff M, Mussig K, Muresan M, Schaffler A, Reisch N, Schott M, Fassnacht M, Opocher G, Klose S, Fottner C, Forrer F, Plockinger U, Petersenn S, Zabolotny D, Kollukch O, Yaremchuk S, Januszewicz A, Walz MK, Eng C, Neumann HP, European-American Pheochromocytoma Study Group (2009) Clinical predictors and algorithm for the genetic diagnosis of pheochromocytoma patients. Clin Cancer Res 15:6378–6385CrossRefPubMed
20.
Lowery AJ, Seeliger B, Alesina PF, Walz MK (2017) Posterior retroperitoneoscopic adrenal surgery for clinical and subclinical Cushing’s syndrome in patients with bilateral adrenal disease. Langenbeck's Arch Surg 402:775–785CrossRef
21.
Petersenn S, Beckers A, Ferone D, Van der Lely AJ, Bollerslev J, Boscaro M, Brue T, Bruzzi P, Casanueva FF, Chanson P (2015) Therapy of endocrine disease: outcomes in patients with Cushing’s disease undergoing transsphenoidal surgery: systematic review assessing criteria used to define remission and recurrence. Eur J Endocrinol 172:R227–R239CrossRefPubMed
22.
Ritzel K, Beuschlein F, Mickisch A, Osswald A, Schneider HJ, Schopohl J, Reincke M (2013) Clinical review: outcome of bilateral adrenalectomy in Cushing’s syndrome: a systematic review. J Clin Endocrinol Metab 98:3939–3948CrossRefPubMed
23.
Sancho JJ, Triponez F, Montet X, Sitges-Serra A (2012) Surgical management of adrenal metastases. Langenbeck's Arch Surg 97:179–194CrossRef
24.
Vazquez BJ, Richards ML, Lohse CM, Thompson GB, Farley DR, Grant CS, Huebner M, Moreno J (2012) Adrenalectomy improves outcomes of selected patients with metastatic carcinoma. World J Surg 36:1400–1405CrossRefPubMed
25.
Bradley CT, Strong VE (2014) Surgical management of adrenal metastases. J Surg Oncol 109:31–35CrossRefPubMed
26.
Welch BT, Callstrom MR, Carpenter PC, Wass CT, Welch TL, Boorjian SA, Nichols DA, Thompson GB, Lohse CM, Erickson D, Leibovich BC, Atwell TD (2014) A single-institution experience in image-guided thermal ablation of adrenal gland metastases. J Vasc Interv Radiol 25:593–598CrossRef
27.
Hiramatsu K, Yamada T, Yukimura Y, Komiya I, Ichikawa K, Ishihara M, Nagata H, Izumiyama T (1981) A screening test to identify aldosterone-producing adenoma by measuring plasma renin activity. Arch Intern Med 141:1589–1593CrossRefPubMed
28.
Gordon RD, Stowasser M, Rutherfort JC (2001) Primary aldosteronism: are we diagnosing and operating on too few patients? World J Surg 25:941–947CrossRefPubMed
29.
Namba K, Tamanaha T, Nakao K, Kawashima ST, Usui T, Tagami T, Okuno H, Shimatsu A, Suzuki T, Naruse M (2012) Confirmatory testing in primary aldosteronism. J Clin Endocrinol Metab 97:1688–1694CrossRef
30.
Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young WF Jr, Montori VM (2008) Case detection, diagnosis and treatment of patients with primary aldosteronism: an Endocrine Society Clinical practise Guideline. J Clin Endocrinol Metab 93:3266–3328CrossRef
31.
Waldmann J, Bartsch DK, Kann PH, Fendrich V, Rothmund M, Langer P (2007) Adrenal involvement in multiple endocrine neoplasia type 1: results of 7 years prospective screening. Langenbeck's Arch Surg 387:437–443CrossRef
32.
Agha A, Hornung M, Iesalnieks I, Schreyer A, Jung EM, Haneya A, Schlitt HJ (2014) Predictors of malignancy in primary aldosteronism. Langenbeck's Arch Surg 399:93–98CrossRef
33.
Rossi GP, Barisa M, Allolio B, Auchus RJ, Amar L, Cohen D, Degenhart C, Deinum J, Fischer E, Gordon R, Kickuth R, Kline G, Lacroix A, Magill S, Miotto D, Naruse M, Nishikawa T, Omura M, Pimenta E, Plouin PF, Quinkler M, Reincke M, Rossi E, Rump LC, Satoh F, Schultze Kool L, Seccia TM, Stowasser M, Tanabe A, Trerotola S, Vonend O, Widimsky J Jr, Wu KD, Wu VC, Pessina AC (2012) The adrenal vein sampling international study AVIS for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab 97:1606–1614CrossRef
34.
Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA (2004) Role for adrenal venous sampling in primary aldosteronism. Surgery 136:1227–1235CrossRef
35.
Lim V, Guo Q, Grant CS, Thompson GB, Richards ML, Farley DR, Young WF Jr (2014) Accuracy of adrenal imaging an adrenal venous sampling in predicting surgical cure of primary aldosteronism. J Clin Endocrinol Metab 99:2712–2719CrossRefPubMed
36.
Tan YY, Ogilvie JB, Triponez F, Caron NR, Kebebew EK, Clark OH, Duh QY (2006) Selective use of adrenal venous sampling in the lateralization of aldosterone-producing adenomas. World J Surg 30:879–887CrossRefPubMed
37.
Oh EM, Lee KE, Yoon K, Kim SY, Kim HC, Youn YK (2012) Value of adrenal venous sampling for lesion localization in primary aldosteronism. World J Surg 36:2522–2527CrossRefPubMed
38.
Pirvu A, Naem N, Baguet JP, Thony F, Chabre O, Chaffanjon P (2014) Is adrenal venous sampling mandatory before surgical decision in case of primary hyperaldosteronism? World J Surg 38:1749–1754CrossRefPubMed
39.
Volpe C, Enberg U, Sjögren A, Wahrenberg H, Jacobsson H, Törring O, Hamberger B, Thorén M (2008) The role of adrenal scintigraphy in the preoperative management of primary aldosteronism. Scand J Surg 97:248–253CrossRefPubMed
40.
Carter Y, Roy M, Sippel RS, Chen H (2012) Persistent hypertension after adrenalectomy for an aldosteron-producing adenoma: weight as a critical prognostic factor for aldosterone’s lasting effect on the cardiac and vascular systems. J Surg Res 177:241–247CrossRefPubMedPubMedCentral
41.
Van der Linden P, Streichen O, Zinzindohoue F, Plouin PF (2012) Blood pressure and medication changes following adrenalectomy for unilateral aldosteronism: a follow-up study. J Hypertens 30:761–769CrossRefPubMed
42.
Wang W, Hu W, Zhang X, Wang B, Bin C, Huang H (2012) Predictors of successful outcome after adrenalectomy for primary aldosteronism. Int Surg 97:104–111CrossRefPubMedPubMedCentral
43.
Strauch B, Petrak O, Zelinka T, Wichterle D, Holaj R, Kasalicky M, Safarik L, Rosa J, Widimsky J Jr (2008) Adrenalectoy improves arterial stiffness in primary aldosteronism. Am J Hypertens 21:1086–1092CrossRefPubMed
44.
Lin YH, Wu XM, Lee HH, Lee JK, Liu YC, Chang HW, Lin CY, Wu VC, Chueh SC, Lin LC, Lo MT, Ho YL, Wu KD, TAIPAI Study Group (2012) Adrenalectomy reverses myocardial fibrosis in patients with primary aldosteronism. J Hypertens 30:1606–1613CrossRefPubMed
45.
Tsuchiya K, Yoshimoto T, Hirata Y (2009) Endothelial dysfunction is related to aldosterone excess and raised blood pressure. Endocr J 56:553–559CrossRefPubMed
46.
Magill SB, Raff H, Shaker JL, Brickner RC, Knechtges TE, Kehoe ME, Findling JW (2001) Comparison of adrenal vein sampling and computed tomography in the differentiation of primary aldosteronism. J Clin Endocrinol Metab 86:1066–1071PubMed
47.
Steichen O, Zinzindohoué F, Plouin PF, Amar L (2012) Outcomes of adrenalectomy in patients with unilateral primary aldosteronism: a review. Horm Metab Res 44:221–227CrossRef
48.
Walz MK, Gwosdz R, Levin SL, Alesina PF, Suttorp AC, Metz KA, Wenger FA, Petersenn S, Mann K, Schmid KW (2008) Retroperitoneoscopic adrenalectomy in Conn’s syndrome caused by adrenal adenomas or nodular hyperplasia. World J Surg 32:847–853CrossRef
49.
Ishidoya S, Ito A, Sakai K (2005) Laparoscopic partial versus total adrenalectomy for aldosterone producing adenoma. J Urol 174:40–43CrossRef
50.
Chen SF, Chueh SC, Wang SM, Wu VC, Pu YS, Wu KD, Huang KH (2014) Clinical outcomes in patients undergoing laparoscopic adrenalectomy for unilateral aldosterone producing adenoma: partial versus total adrenalectomy. J Endourol 28:1103–1106CrossRef
51.
Fu B, Zhang X, Wang GX, Lang B, Ma X, Li HZ, Wang BJ, Shi TP, Ai X, Zhou HX, Zheng T (2011) Long-term results of a prospective, randomized trial comparing retroperitoneoscopic partial versus total adrenalectomy for aldosterone producing adenoma. J Urol 185:1578–1582CrossRef
52.
Nieman LK, Biller BM, Findling JW, Murad MH, Newell-Price J, Savage MO, Tabarin A. Endocrine Society (2015) Treatment of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 100:2807–2831CrossRefPubMedPubMedCentral
53.
Arnaldi G, Trementino L (2016) Update on hypercortisolism therapy. Front Horm Res 46:87–105CrossRefPubMed
54.
Buliman A, Tataranu LG, Paun DL, Mirica A, Dumitrache C (2016) Cushing’s disease: a multidisciplinary overview of the clinical features, diagnosis, and treatment. J Med Life 9:12–18PubMedPubMedCentral
55.
Young WF Jr, du Plessis H, Thompson GB, Grant CS, Farley DR, Richards ML, Erickson D, Vella A, Stanson AW, Carney JA, Abboud CF, Carpenter PC (2008) The clinical conundrum of corticotropin-independent autonomous cortisol secretion in patients with bilateral adrenal masses. World J Surg 32:856–862CrossRefPubMed
56.
Reincke M, Ritzel K, Oßwald A, Berr C, Stalla G, Hallfeldt K, Reisch N, Schopohl J, Beuschlein F (2015) A critical reappraisal of bilateral adrenalectomy for ACTH-dependent Cushing’s syndrome. Eur J Endocrinol 173:23–32CrossRef
57.
Seki T, Yasuda A, Kitajima N, Oki M, Takagi A, Nakamura N, Hanai K, Terachi T, Fukagawa M (2015) Adrenal venous sampling is useful for a definitive diagnosis in Cushing’s syndrome with bilateral adrenal tumors. Tokai J Exp Clin 40:149–156
58.
Lack EE (2007) Tumors of the adrenal glands and the extraadrenal paraganglia. AFIP Atlas of tumor pathology. American Registry of Pathology, Armed Forces Institute of Pathology, Washington, pp 1–500
59.
Gaujoux S, Brennan MF (2012) Recommendation for standardized surgical management of primary adrenocortical carcinoma. Surgery 152:123–132CrossRefPubMed
60.
Else T, Kim AC, Sabolch A, Raymond VM, Kandathil A, Caoili EM, Jolly S, Miller BS, Giordano TJ, Hammer GD (2014) Adrenocortical carcinoma. Endocr Rev 35:282–326CrossRefPubMed
61.
Stigliano A, Chiodini I, Giordano R, Faggiano A, Canu L, Della Casa S, Loli P, Luconi M, Mantero F, Terzolo M (2016) Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE). J Endocrinol Invest 39:103–121
62.
Eisenhofer G, Keiser H, Friberg P, Mezey E, Huynh TT, Hiremagalur B, Ellingson T, Duddempudi S, Eijsbouts A, Lenders JW (1998) Plasma metanephrines are markers of pheochromocytoma produced by catechol-O methyltransferase within tumors. J Clin Endocrinol Metab 83:2175–2185CrossRefPubMed
63.
Sawka AM, Jaeschke R, Singh RJ, Young WF (2003) A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab 88:553–558CrossRefPubMed
64.
Osinga TE, van der Horst-Schrivers AN, van Faassen M, Kerstens MN, Dullart RP, Pacak K, Links TP, Kema IP (2016) Mass spectrometic quantification of salivary metanephrines-a study in healthy subjects. Clin Biochem 49:983–938CrossRefPubMedPubMedCentral
65.
Eisenhofer G, Goldstein DS, Walther MM, Friberg P, Lenders JW, Keiser HR, Pacak K (2003) Biochemical diagnosis of pheochromocytoma:how to distinguish true- from false positive test results. J Clin Endocrinol Metab 88:2656–2666CrossRefPubMed
66.
Därr R, Lenders JW, Stange K, Kindel B, Hofbauer LC, Bornstein SR, Eisenhofer G (2013) Diagnosis of pheochromocytoma and paraganglioma: the clonidine suppression test in patients with borderline elevations of plasma free normetanephrine. Dtsch Med Wochenschr 138:76–81CrossRefPubMed
67.
68.
Motta-Ramirez GA, Remer EM, Herts BR, Gill IS, Hamrahian AH (2005) Comparison of CT findings in symptomatic and incidentally discovered pheochromocytomas. Am J Roentgenol 185:684–688CrossRef
69.
Blake MA, Krishnamoorthy SK, Boland GW, Sweeney AT, Pitman MB, Harisinghani M, Mueller PR, Hahn PF (2003) Low-density pheochromocytoma on CT: a mimicker of adrenal adenoma. Am J Roentgenol 181:1663–1668CrossRef
70.
Sahdev A, Sohaib A, Monson JP, Grossman AB, Chew SL, Reznek RH (2005) CT and MR imaging of unusual locations of extra-adrenal paragangliomas (pheochromocytomas). Eur Radiol 15:85–92CrossRefPubMed
71.
Van Berkel A, Pacak K, Lenders JWM (2014) Should every patient diagnosed with a pheochromocytoma have a 123I-MIBG scintigraphy? Clin Endocrinol 81:329–333CrossRef
72.
Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young WF (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:1915–1942CrossRefPubMed
73.
Shulkin BL, Thompson NW, Shapiro B, Francis IR, Sisson JC (1999) Pheochromocytomas: imaging with 2-[fluorine-18]fluoro-2-deoxy-D-glucose PET. Radiology 212:35–41CrossRefPubMed
74.
Mann GN, Link JM, Pham P, Pickett CA, Byrd DR, Kinahan PE, Krohn KA, Mankoff DA (2006) [11C]metahydroxyephedrine and [18F]fluorodeoxyglucose positron emission tomography improve clinical decision making in suspected pheochromocytoma. Ann Surg Oncol 13:187–197CrossRefPubMed
75.
Timmers HJ, Eisenhofer G, Carrasquillo JA, Chen CC, Whatley M, Ling A, Adams KT, Pacak K (2009) Use of 6-[18F]-fluorodopamine positron emission tomography (PET) as first-line investigation for the diagnosis and localization of non-metastatic and metastatic phaeochromocytoma (PHEO). Clin Endocrinol 71:11–17CrossRef
76.
Pacak K, Eisenhofer G, Ahlman H, Bornstein SR, Gimenez-Roqueplo AP, Grossman AB, Kimura N, Mannelli M, McNicol AM, Tischler AS (2007) Pheochromocytoma: recommendations for clinical practice from the First International Symposium. Nat Clin Pract Endocrinol Metab 3:92–102CrossRefPubMed
77.
Ellis RJ, Patel D, Prodanov T, Sadowski S, Nilubol N, Adams K, Steinberg SM, Pacak K, Kebebew E (2013) Response after surgical resection of metastatic pheochromocytoma and paraganglioma: can postoperative biochemical remission be predicted? J Am Coll Surg 217:489–496CrossRefPubMedPubMedCentral
78.
Stefanidis D, Goldfarb M, Kercher KW, Hope WW, Richardson W, Fanelli RD (2013) SAGES guidelines for minimally invasive treatment of adrenal pathology. Surg Endosc 27:3960–3980CrossRefPubMed
79.
Walz MK, Peitgen K, Neumann HP, Janssen OE, Philipp T, Mann K (2002) Endoscopic treatment of solitary, bilateral, multiple, and recurrent pheochromocytomas and paragangliomas. World J Surg 26:1005–1012CrossRefPubMed
80.
Brunt LM, Lairmore TC, Doherty GM, Quasebarth MA, DeBenedetti M, Moley JF (2002) Adrenalectomy for familial pheochromocytoma in the laparoscopic era. Ann Surg 235:713–720CrossRefPubMedPubMedCentral
81.
Yip L, Lee JE, Shapiro SE, Waguespack SG, Sherman SI, Hoff AO, Gagel RF, Arens JF, Evans DB (2004) Surgical management of hereditary pheochromocytoma. J Am Coll Surg 198:525–534CrossRefPubMed
82.
Young WF (2007) The incidentally discovered adrenal mass. N Engl J Med 356:601–610CrossRef
83.
Reincke M, Slawick M Adrenal incidentalomas. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO (eds) Endotext [Internet]. MDText.com, Inc., South Dartmouth, pp 2000–2010
84.
Terzolo M, Stigliano A, Chiodini I, Loli P, Furlani L, Arnaldi G, Reimondo G, Pia A, Toscano V, Zini M, Borretta G, Papini E, Garofalo P, Allolio B, Dupas B, Mantero F, Tabarin A (2011) Italian Association of Clinical Endocrinologists (AME) position statement on adrenal incidentaloma. Eur J Endocrinol 164:851–870CrossRefPubMed
85.
Petersenn S, Richter PA, Broemel T, Ritter CO, Deutschbein T, Beil FU, Allolio B, Fassnacht M, German ACC Study Group (2015) Computed tomography criteria for discrimination of adrenal adenomas and adrenocortical carcinomas: analysis of the German ACC registry. Eur J Endocrinol 172:415–422CrossRefPubMed
86.
Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, Tabarin A, Terzolo M, Tsagarakis S, Dekkers OM (2016) Management of adrenal incidentalomas: European Society of Endocrinology clinical practice guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 175:G1–G34CrossRefPubMed
87.
88.
Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA, Harris EL, Lee JK, Oertel YC, Posner MC, Schlechte JA, Wieand HS (2003) Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med 138:424–429CrossRef
89.
Fernández-Cruz L, Sáenz A, Benarroch G, Sabater L, Taurá P (1996) Does hormonal function of the tumor influence the outcome of laparoscopic adrenalectomy? Surg Endosc 10:1088–1091CrossRefPubMed
90.
Shen WT, Lim RC, Siperstein AE, Clark OH, Schecter WP, Hunt TK, Horn JK, Duh QY (1999) Laparoscopic vs open adrenalectomy for the treatment of primary hyperaldosteronism. Arch Surg:134628–134631
91.
Natkaniec M, Pędziwiatr M, Wierdak M (2016) Laparoscopic transperitoneal lateral adrenalectomy for large adrenal tumors. Urol Int 97:165–172CrossRefPubMed
92.
Arlt W, Biehl M, Taylor AE, Hahner S, Libé R, Hughes BA, Schneider P, Smith DJ, Stiekema H, Krone N, Porfiri E, Opocher G, Bertherat J, Mantero F, Allolio B, Terzolo M, Nightingale P, Shackleton CH, Bertagna X, Fassnacht M, Stewart PM (2011) Urine steroid metabolomics as a biomarker tool for detecting malignancy in adrenal tumors. J Clin Endocrinol Metab 96:3775–3784CrossRefPubMedPubMedCentral
93.
Zhang HM, Perrier ND, Grubbs EG, Sircar K, Ye ZX, Lee JE, Ng CS (2012) CT features and quantification of the characteristics of adrenocortical carcinomas on unenhanced and contrast-enhanced studies. Clin Radiol 67:38–46CrossRefPubMed
94.
Young WF Jr (2011) Conventional imaging in adrenocortical carcinoma: update and perspectives. Horm Cancer 2:341–347CrossRefPubMed
95.
Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB, Reznek RH (2011) Adrenocortical carcinoma: the range of appearances on CT and MRI. Am J Roentgenol 196:706–714CrossRef
96.
Berutti A, Baudin E, Gelderblum H, Haak HR, Porpiglia F, Fassnacht M, Pentheroudakis G (2012) Adrenal Cancer: ESMO Clincal Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 23(Suppl 7):131–138
97.
Reibetanz J, Jurowich C, Erdogan I, Nies C, Rayes N, Dralle H, Behrend M, Allolio B, Fassnacht M, German ACC Study Group (2012) Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg 255:363–369CrossRefPubMed
98.
Freire DS, Siqueira SA, Zerbini MC, Wajchenberg BL, Corrêa-Giannella ML, Lucon AM, Pereira MA (2013) Development and internal validation of an adrenal cortical carcinoma prognostic score for predicting the risk of metastasis and local recurrence. Clin Endocrinol 79:468–745CrossRef
99.
Gratian L, Pura J, Dinan M, Reed S, Scheri R, Roman S, Sosa JA (2014) Treatment patterns and outcomes for patients with adrenocortical carcinoma associated with hospital case volume in the United States. Ann Surg Oncol 213:509–514
100.
Miller BS, Gauger PG, Hammer GD, Doherty GM (2012) Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic adrenalectomy than after open adrenalectomy. Surgery 152:1150–1157CrossRefPubMed
101.
Porpiglia F, Fiori C, Daffara FC, Zaggia B, Ardito A, Scarpa RM, Papotti M, Berruti A, Scagliotti GV, Terzolo M (2016) Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome? J Endocrinol Investig 39:465–471CrossRef
102.
Turbendian HK, Strong VE, Hsu M, Ghossein RA, Fahey TJ 3rd (2010) Adrenocortical carcinoma: the influence of large vessel extension. Surgery 148:1057–1064CrossRefPubMed
103.
Mihai R, Iacobone M, Makay O, Moreno P, Frilling A, Kraimps JL, Soriano A, Villar del Moral J, Barczynski M, Durán MC, Sadler GP, Niederle B, Dralle H, Harrison B, Carnaille B (2012) Outcome of operation in patients with adrenocortical cancer invading the inferior vena cava-a European Society of Endocrine Surgeons (ESES) survey. Langenbeck's Arch Surg 397:225–231CrossRef
104.
Fassnacht M, Kroiss M, Allolio B (2013) Update in adrenocortical carcinoma. J Clin Endocrinol Metab 98:4551–4564CrossRefPubMed
105.
Saade N, Sadler C, Goldfarb M (2015) Impact of regional lymph node dissection on disease specific survival in adrenal cortical carcinoma. Horm Metab Res 47:820–825CrossRefPubMed
106.
Mihai R (2015) Diagnosis, treatment and outcome of adrenocortical cancer. Br J Surg 102:291–306CrossRefPubMed
107.
Nilubol N, Patel D, Kebebew E (2016) Does lymphadenectomy improve survival in patients with adrenocortical carcinoma? A population-based study. World J Surg 40:697–705CrossRefPubMed
108.
Bilimoria KY, Shen WT, Elaraj D, Bentrem DJ, Winchester DJ, Kebebew E, Sturgeon C (2008) Adrenocortical carcinoma in the United States: treatment utilization and prognostic factors. Cancer 113:3130–3136CrossRefPubMed
109.
Icard P, Goudet P, Charpenay C, Andreassian B, Carnaille B, Chapuis Y, Cougard P, Henry JF, Proye C (2001) Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons study group. World J Surg 25:891–897CrossRefPubMed
110.
Polat B, Fassnacht M, Pfreundner L, Guckenberger M, Bratengeier K, Johanssen S, Kenn W, Hahner S, Allolio B, Flentje M (2009) Radiotherapy in adrenocortical carcinoma. Cancer 115:2816–2823CrossRefPubMed
111.
Bednarski BK, Habra MA, Phan A, Milton DR, Wood C, Vauthey N, Evans DB, Katz MH, Ng CS, Perrier ND, Lee JE, Grubbs EG (2014) Borderline resectable adrenal cortical carcinoma: a potential role for preoperative chemotherapy. World J Surg 38:1318–1327CrossRefPubMed
112.
Bellantone R, Ferrante A, Boscherini M, Lombardi CP, Crucitti P, Crucitti F, Favia G, Borrelli D, Boffi L, Capussotti L, Carbone G, Casaccia M, Cavallaro A, Del Gaudio A, Dettori G, Di Giovanni V, Mazziotti A, Marrano D, Masenti E, Miccoli P, Mosca F, Mussa A, Petronio R, Piat G, Ruberti U, Serio G, Marzano L (1997) Role of reoperation in recurrence of adrenal cortical carcinoma: results from 188 cases collected in the Italian National Registry for Adrenal Cortical Carcinoma. Surgery 122:1212–1218CrossRefPubMed
113.
Fassnacht M, Hahner S, Polat B, Koschker AC, Kenn W, Flentje M, Allolio B (2006) Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma. J Clin Endocrinol Metab 91:4501–4504CrossRefPubMed
114.
Kemp CD, Ripley RT, Mathur A, Steinberg SM, Nguyen DM, Fojo T, Schrump DS (2011) Pulmonary resection for metastatic adrenocortical carcinoma: the National Cancer Institute experience. Ann Thorac Surg 92:1195–1200CrossRefPubMed
115.
Ripley RT, Kemp CD, Davis JL, Langan RC, Royal RE, Libutti SK, Steinberg SM, Wood BJ, Kammula US, Fojo T, Avital I (2011) Liver resection and ablation for metastatic adrenocortical carcinoma. Ann Surg Oncol 18:1972–1979CrossRefPubMedPubMedCentral
116.
Kerkhofs TM, Verhoeven RH, Bonjer HJ, van Dijkum EJ, Vriens MR, De Vries J, Van Eijck CH, Bonsing BA, Van de Poll-Franse LV, Haak HR, Dutch Adrenal Network (2013) Surgery for adrenocortical carcinoma in The Netherlands: analysis of the national cancer registry data. Eur J Endocrinol 169:83–89CrossRefPubMed
117.
Dy BM, Wise KB, Richards ML, Young WF, Grant CS, Bible KC, Rosedahl J, Harmsen WS, Farley DR, Thompson GB (2013) Operative intervention for recurrent adrenocortical cancer. Surgery 154:1292–1299CrossRefPubMed
118.
Erdogan I, Deutschbein T, Jurowich C, Kroiss M, Ronchi C, Quinkler M, Waldmann J, Willenberg HS, Beuschlein F, Fottner C, Klose S, Heidemeier A, Brix D, Fenske W, Hahner S, Reibetanz J, Allolio B, Fassnacht M, German Adrenocortical Carcinoma Study Group (2013) The role of surgery in the management of recurrent adrenocortical carcinoma. J Clin Endocrinol Metab 98:181–191CrossRefPubMed
119.
Schteingart DE, Doherty GM, Gauger PG, Giordano TJ, Hammer GD, Korobkin M, Worden FP (2005) Management of patients with adrenal cancer: recommendations of an international consensus conference. Endocr Relat Cancer 12:667–680CrossRefPubMed
120.
Hero B, Berthold F (2011) Neuroblastom. Leitlinie der Gesellschaft für Pädiatrische Onkologie und Hämatologie. AWMF-Register Nr. 025/008 online
121.
Shawa H, Elsayes KM, Javadi S, Morani A, Williams MD, Lee JE, Waguespack SG, Busaidy NL, Vassilopoulou-Sellin R, Jimenez C, Habra MA (2014) Adrenal ganglioneuroma: features and outcomes of 27 cases at a referral cancer centre. Clin Endocrinol 80:342–347CrossRef
122.
Patel VG, Babalola OA, Fortson JK, Weaver WL (2006) Adrenal myelolipoma: a report of a case and review of the literature. Am Surg 72:649–654PubMed
123.
Uberoi J, Munver R (2009) Surgical management of metastases to the adrenal gland: open, laparoscopic, and ablative approaches. Curr Urol Rep 10:67–72CrossRefPubMed
124.
Lenert JT, Barnett CC Jr, Kudelka AP, Sellin RV, Gagel RF, Prieto VG, Skibber JM, Ross MI, Pisters PW, Curley SA, Evans DB, Lee JE (2001) Evaluation and surgical resection of adrenal masses in patients with a history of extra-adrenal malignancy. Surgery 130:1060–1067CrossRefPubMed
125.
Lumb G, Mackenzie DH (1959) The incidence of metastases in adrenal glands and ovaries removed for carcinoma of the breast. Cancer 12:521–526CrossRefPubMed
126.
Korobkin M, Giordano TJ, Brodeur FJ, Francis IR, Siegelman ES, Quint LE, Dunnick NR, Heiken JP, Wang HH (1996) Adrenal adenomas: relationship between histologic lipid and CT and MR findings. Radiology 200:743–747CrossRefPubMed
127.
Caoili EM, Korobkin M, Francis IR, Cohan RH, Platt JF, Dun-nick NR, Raghupathi KI (2002) Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology 222:629–633CrossRefPubMed
128.
Haider MA, Ghai S, Jhaveri K, Lockwood G (2004) Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology 231:711–716CrossRefPubMed
129.
Song JH, Chaudhry FS, Mayo-Smith WW (2008) The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. Am J Roentgenol 190:1163–1168CrossRef
130.
Pfannschmidt J, Schlolaut B, Muley T, Hoffmann H, Dienemann H (2005) Adrenalectomy for solitary adrenal metastases from non-small cell lung cancer. Lung Cancer 49:203–207CrossRefPubMed
131.
Mercier O, Fadel E, de Perrot M, Mussot S, Stella F, Chapelier A, Dartevelle P (2005) Surgical treatment of solitary adrenal metastasis from non-small cell lung cancer. J Thorac Cardiovasc Surg 130:136–140CrossRefPubMed
132.
Muth A, Persson F, Jansson S, Johanson V, Ahlman H, Wangberg B (2010) Prognostic factors for survival after surgery for adrenal metastasis. Eur J Surg Oncol 36:699–704CrossRefPubMed
133.
Young WF Jr (2003) Primary aldosteronism—changing concepts in diagnosis and treatment. Endocrinology 144:2208–2213CrossRef
134.
Funder JW, Carey RM, Matero F, Murad MH, Reincke M, Shibata H, Stowasser M, Young WF (2016) Guidelines on primary aldosteronism. J Clin Endocrinol Metab 101:1889–1916CrossRef
135.
Sawka AM, Young WF, Thompson GB, Grant CS, Farley DR, Leibson C, van Heerden JA (2001) Primary aldosteronism: factors associated with normalization of blood pressure after surgery. Ann Intern Med 135:258–226CrossRefPubMed
136.
Harris DA, Au-Yong I, Basnyat PS, Sadler GP, Wheeler MH (2003) Review of surgical management of aldosterone secreting tumours of the adrenal cortex. Eur J Surg Oncol 29:467–474CrossRefPubMed
137.
Lim PO, Young WF, MacDonald TM (2001) A review of the medical treatment of primary aldosteronism. J Hypertens 19:353–361CrossRefPubMed
138.
Montori VM, Young WF (2002) Use of plasma aldosterone concentration-to-plasma renin activity ratio as a screening test for primary aldosteronism: a systematic review of the literature. Endocrinol Metab Clin N Am 31:619–632CrossRef
139.
Parthasarathy HK, Ménard J, White WB, Young WF, Williams GH, Williams B, Ruilope LM, McInnes GT, Connell JM, MacDonald TM (2011) A double-blind, randomized study comparing the antihypertensive effect of eplerenone and spironolactone in patients with hypertension and evidence of primary aldosteronism. J Hypertens 29:980–990CrossRefPubMed
140.
Karagiannis A, Tziomalos K, Papageorgiou A, Kakafika AI, Pagourelias ED, Anagnostis P, Athyros VG, Mikhailidis DP (2008) Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin Pharmacother 9:509–515CrossRefPubMed
141.
Sood A, Majumder K, Kachroo N, Sammon JD, Abdollah F, Schmid M, Hsu L, Jeong W, Meyer CP, Hanske J, Kalu R, Menon M, Trinh QD (2016) Adverse event rates, timing of complications, and the impact of specialty on outcomes following adrenal surgery: an analysis of 30-day outcome data from the American college of surgeons national surgical quality improvement program (ACS-NSQIP). Urology 90:62–68CrossRefPubMed
142.
Niemann LK (2015) Cushing’s syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol 173:M33–M38CrossRef
143.
Gumbs AA, Gagner M (2006) Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metab 20:483–499CrossRefPubMed
144.
145.
Hahner S, Allolio B (2005) Management of adrenal insufficiency in different clinical settings. Expert Opin Pharmacother 6:2407–2417CrossRefPubMed
146.
Ortiz DI, Findling JW, Carroll TB, Javorsky BR, Carr AA, Evans DB, Yen TW, Wang TS (2016) Cosyntropin stimulation testing on postoperative day 1 allows for selective glucocorticoid replacement therapy after adrenalectomy for hypercortisolism: results of a novel, multidisciplinary institutional protocol. Surgery 159:259–266CrossRefPubMed
147.
der Zee V, de Boer A (2014) Pheochromocytoma: a review on preoperative treatment with phenoxybenzamine or doxazosin. Neth J Med 72:190–201PubMed
148.
Shao Y, Chen R, Shen ZJ, Teng Y, Huang P, Rui WB, Xie X, Zhou WL (2011) Preoperative alpha blockade for normotensive pheochromocytoma: is it necessary. J Hypertens 29:2429–2432CrossRefPubMed
149.
Groeben H, Nottebaum BJ, Alesina PF, Traut A, Neumann HP, Walz MK (2017) Perioperative alpha-receptor blockade in pheochromocytoma surgery: an observational case series. Br J Anaesth 118:182–189CrossRefPubMed
150.
Lafont M, Fagour C, Haissaguerre M, Darancette G, Wagner T, Corcuff JB, Tabarin A (2015) Perioperative hemodynamic instability in normotensive patients with incidentally discovered pheochromocytomas. J Clin Endocrinol Metab 100:417–421CrossRefPubMed
151.
152.
Ong KR, Woodward ER, Killick P, Lim C, Macdonald F, Maher ER (2007) Genotype-phenotype correlations in von Hippel-Lindau disease. Hum Mutat 28:143–149CrossRefPubMed
153.
Gimenez-Roqueplo AP, Caumont-Prim A, Houzard C, Hignette C, Hernigou A, Halimi P, Niccoli P, Leboulleux S, Amar L, Borson-Chazot F, Cardot-Bauters C, Delemer B, Chabolle F, Coupier I, Libé R, Peitzsch M, Peyrard S, Tenenbaum F, Plouin PF, Chatellier G, Rohmer V (2013) Imaging work-up for screening of paraganglioma and pheochromocytoma in SDHx mutation carriers: a multicenter prospective study from the PGL.EVA Investigators. J Clin Endocrinol Metab 98:162–167CrossRef
154.
Chrisoulidou A, Kaltsas G, Ilias I, Grossman AB (2007) The diagnosis and management of malignant phaeochromocytoma and paraganglioma. Endocr Relat Cancer 14(569):585
155.
Amar L, Fassnacht M, Gimenez-Roqueplo AP, Januszewicz A, Prejbisz A, Timmers H, Plouin PF (2012) Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma. Horm Metab Res 44:385–389CrossRefPubMed
156.
Favier J, Amar L, Gimenez-Roqueplo AP (2015) Pheochromocytoma and paraganglioma: from genetic to clinics. Nat Rev Endocrinol 11:101–111CrossRefPubMed
157.
Eisenhofer G, Lenders JW, Siegert G, Bornstein SR, Friberg P, Milosevic D, Mannelli M, Linehan WM, Adams K, Timmers HJ, Pacak K (2012) Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer 48:1739–1749CrossRefPubMed
158.
Eisenhofer G, Peitzsch M (2014) Laboratory evaluation of pheochromocytoma and paraganglioma. Clin Chem 60:1486–1499CrossRefPubMed
159.
Neumann HP, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C (2004) Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations. J Am Ass Med 292:943–951CrossRef
160.
Rufini V, Treglia G, Castaldi P, Perotti G, Giordano A (2013) Comparison of metaiodobenzyl-guanidine scintigraphy with positron emission tomography in the diagnostic work-up of pheochromocytoma and paraganglioma: a systematic review. Q J Nucl Med Mol Imaging 57:122–133PubMed
161.
Cascón A, Comino-Méndez I, Currás-Freixes M, de Cubas AA, Contreras L, Richter S, Peitzsch M, Mancikova V, Inglada-Pérez L, Pérez-Barrios A, Calatayud M, Azriel S, Villar-Vicente R, Aller J, Setién F, Moran S, Garcia JF, Río-Machín A, Letón R, Gómez-Graña Á, Apellániz-Ruiz M, Roncador G, Esteller M, Rodríguez-Antona C, Satrústegui J, Eisenhofer G, Urioste M, Robledo M (2015) Whole-exome sequencing identifies MDH2 as a new familial paraganglioma gene. J Natl Cancer Inst 107:5CrossRef
Metadaten
Titel
Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK)
verfasst von
K. Lorenz
P. Langer
B. Niederle
P. Alesina
K. Holzer
Ch. Nies
Th. Musholt
P. E. Goretzki
N. Rayes
M. Quinkler
J. Waldmann
D. Simon
A. Trupka
R. Ladurner
K. Hallfeldt
A. Zielke
D. Saeger
Th. Pöppel
G. Kukuk
A. Hötker
P. Schabram
S. Schopf
C. Dotzenrath
P. Riss
Th. Steinmüller
I. Kopp
C. Vorländer
M. K. Walz
D. K. Bartsch
Publikationsdatum
01.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 4/2019
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-019-01768-z

Weitere Artikel der Ausgabe 4/2019

Langenbeck's Archives of Surgery 4/2019 Zur Ausgabe

Original Article

Blurring the boundary between open abdomen treatment and ventral hernia repair

Original Article

Laparoscopic inguinal hernia repair with a joystick-guided robotic scope holder (Soloassist II®): retrospective comparative study with human assistant

Original Article

Tumour stage and resection margin status are independent survival factors following partial pancreatoduodenectomy for duodenal adenocarcinoma

Original Article

Effect of surgeons’ annual operative volume on the risk of permanent Hypoparathyroidism, recurrent laryngeal nerve palsy and Haematoma following thyroidectomy: analysis of United Kingdom registry of endocrine and thyroid surgery (UKRETS)

Original Article

Laser speckle contrast imaging and quantitative fluorescence angiography for perfusion assessment

Original Article

Mild sporadic primary hyperparathyroidism: high rate of multiglandular disease is associated with lower surgical cure rate

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.