[EUROCRINE®: adrenal surgery 2015-2019- surprising initial results].

Staubitz, J I; Clerici, T; Riss, P; Watzka, F; Bergenfelz, A; Bareck, E; Fendrich, V; Goldmann, A; Grafen, F; Heintz, A; Kaderli, R M; Karakas, E; Kern, B; Matter, M; Mogl, M; Nebiker, C A; Niederle, B; Obermeier, J; Ringger, A; Schmid, R; ... (2021). [EUROCRINE®: adrenal surgery 2015-2019- surprising initial results]. Der Chirurg, 92(5), pp. 448-463. Springer 10.1007/s00104-020-01277-6

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BACKGROUND

Since 2015 operations performed in the field of endocrine surgery have been entered into the European registry EUROCRINE®. The aim of this analysis was a description of the current healthcare situation for adrenal surgery in a homogeneous healthcare environment corresponding to the German-speaking countries-or to the presence of the working group on surgical endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)-and to assess the adherence to current international treatment guidelines.

METHODS

An analysis of the preoperative diagnostics, the applied operative techniques and the underlying histological entities was carried out for all operations on adrenal glands in Germany, Switzerland and Austria, which were registered in EUROCRINE® from 2015 to 2019.

RESULTS

In the total of 21 participating hospitals from the German-speaking EUROCRINE® countries, 658 operations on adrenal glands were performed. In 90% of cases unilateral adrenalectomy was performed, in 3% bilateral adrenalectomy and in 7% other resection procedures. In 41% the main histological diagnosis was an adrenocortical adenoma. In 15% malignant entities were detected on final histology, including 6% adrenocortical carcinoma (ACC) and 8% metastases to the adrenal glands. 23% of the operations were performed for pheochromocytoma. This entity was primarily resected using minimally invasive approaches (82%), whereas minimally invasive techniques were applied in 28% for ACC and in 66% for metastases to the adrenal glands.

CONCLUSION

Surprisingly, following adrenocortical adenoma and pheochromocytoma, the third most common histological entity was metastasis of different extra-adrenal primary tumors to the adrenal gland. Of the operations for ACC 28% were scheduled for minimally invasive techniques, but conversion to open surgery was necessary in 20%. The analysis revealed discrepancies between treatment reality and international guideline recommendations that raise questions, which will be addressed by an updated version of the EUROCRINE® module for the documentation of adrenal surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Kaderli, Reto Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1433-0385

Publisher:

Springer

Language:

German

Submitter:

Rahel Fuhrer

Date Deposited:

23 Dec 2020 12:25

Last Modified:

30 Apr 2021 01:32

Publisher DOI:

10.1007/s00104-020-01277-6

PubMed ID:

32945919

Uncontrolled Keywords:

Adrenal metastasis Adrenalectomy Adrenocortical carcinoma EUROCRINE® registry Laparoscopic adrenalectomy Retroperitoneoscopic adrenalectomy

BORIS DOI:

10.48350/149994

URI:

https://boris.unibe.ch/id/eprint/149994

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