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N o v e m b e r 1 2 - 1 3 , 2 0 1 8 | R o m e , I t a l y
Joint Event on
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
Surgery and Anesthesia 2018 & Euro Gastro Congress 2018 Case Reports in Surgery and Invasive Procedures| Volume 2
&
GASTROENTEROLOGY
3rd International Conference on
SURGERY AND ANESTHESIA
International Conference on
Yiannakopoulou E, Case Rep Surg Invasive Proced 2018, Volume 2
PARTIAL ADRENALECTOMY FOR FAMILIAL
AND HEREDITARY PHEOCHROMOCYTOMA
Yiannakopoulou E
University of West Attica, Greece
Traditionally total adrenalectomy has been advocated for the treatment of
bilateral adrenal disorders especially in cases of hereditary syndromes
like multiple endocrine neoplasia type 2, Von Hippel–Lindau disease and neu-
rofibromatosis type I. However, currently it is well recognized that total adre-
nalectomy is associated with the morbidity of medical adrenal replacement
therapy. Lifelong adrenal replacement therapy after bilateral adrenalectomy
may predispose patients to osteoporosis, Addisonian crisis and decreased
quality of life. In that context, partial adrenalectomy has been suggested for
patients with functioning and non-functioning benign adrenal tumours espe-
cially in the case of hereditary adrenal-producing syndromes, bilateral or mul-
tifocal lesions or solitary adrenal glands. Advantages of partial adrenalecto-
my include preservation of adrenocortical function and catecholamine excre-
tion while resultant avoidance of post-operative chronic steroid replacement.
Cortical sparing adrenalectomy has been described in both hereditary and
sporadic pheochromocytoma. The use of cortical sparing adrenalectomy is
highly debated in the case of unilateral pheochromocytoma due to the diffi-
culty in excluding malignancy. The majority of literature data focus on heredi-
tary pheochromocytoma patients with RET or VHL mutations. The low risk of
malignancy and high risk of bilateral tumours are obvious in the above genet-
ic syndromes especially in MEN2. Recurrence rate is estimated at about 10%
for pheochromocytoma. Overall steroid dependence rate is estimated at 90%.
Long term follow up of the patients has not been standardized. The surgical
technique has not been standardized and open questions remain regarding
the tumour margin, the adrenal vein preservation, the means of haemostasis.
The lecture will focus on the indications of partial adrenalectomy in the case
of familial and hereditary pheochromocytoma, surgical technique, on compli-
cations as well as on outcome.
Yiannakopoulou E is an endocrine surgeon, Breast sur-
geon and pharmacologist. Current position: Faculty in the
Department of Biomedical Sciences, Faculty of Health
and Caring Professions, University of West Attica, Athens,
Greece; Director of her own private medical practice at
University of Strasbourg, France.
BIOGRAPHY