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Exp Clin Endocrinol Diabetes 2019; 127(02/03): 137-146
DOI: 10.1055/a-0654-5251
Review
© Georg Thieme Verlag KG Stuttgart · New York

Perioperative Management of Endocrine Active Adrenal Tumors

Florentine Schreiner   *
1   Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
,
Gurpreet Anand   *
1   Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
,
Felix Beuschlein
1   Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
2   Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
› Author Affiliations
Further Information

Publication History

received 13 May 2018
revised 22 June 2018

accepted 05 July 2018

Publication Date:
14 August 2018 (online)

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Abstract

Endocrine active adrenal tumors are associated with a relevant risk of complications during surgery, either due to direct hemodynamic effects of the hormone excess or due to hormone related comorbidities. Over the last decades, careful preoperative evaluation and improved peri-interventional medical management of affected patients has resulted in a significant reduction of perioperative complications. In addition, improvement in anesthesia and surgical techniques with the feasibility of laparoscopic adrenalectomy have contributed to reduce morbidity. Nevertheless, there are still several challenges to be considered in the perioperative care of these patients. Due to the rarity of functionally active adrenal tumors, there are no prospective data available to guide clinical management. Accordingly, most recommendations are based on retrospective data analysis, expert opinion or carry weak evidence based on small series or case reports. The aim of this review is to summarize the current knowledge and to suggest practical approaches to reduce perioperative complications in endocrine active adrenal tumors. This review exclusively deals with data from adult patients with functionally active adrenal tumors.

Key words

pheochromocytoma - paraganglioma - primary aldosteronism - Cushing’s syndrome - surgery - laparoscopy - perioperative management

* Both authors contributed equally to the manuscript.


 

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