Complications after bilateral adrenalectomy for phaeochromocytoma in multiple endocrine neoplasia type 2--a plea to conserve adrenal function.

Abstract

OBJECTIVE:

To evaluate the complications of the adrenocortical supplementation that is needed after bilateral adrenalectomy for phaeochromocytoma in patients with multiple endocrine neoplasia (MEN) type 2 syndrome.

DESIGN:

Retrospective study.

SETTING:

University hospital, The Netherlands.

MATERIALS:

28 patients with MEN 2 who underwent total adrenalectomy for phaeochromocytoma between 1972 and 1996.

MAIN OUTCOME MEASURES:

Perioperative morbidity and mortality, histopathological findings, complications of adrenocortical supplementation therapy.

RESULTS:

22 patients had bilateral phaeochromocytomas on histopathological examination (79%) and 6 patients had initially unilateral phaeochromocytomas There was no operative mortality or substantial morbidity except for one splenic injury that necessitated splenectomy. During a mean follow-up period of 14 years (range 1-26) nine patients (32%) had a total of 19 Addisonian crises that necessitated admission to hospital. One patient died of an unrecognised Addisonian crisis.

CONCLUSION:

Complications of adrenocortical supplementation therapy are considerable, but they can be reduced when unilateral adrenalectomy is done for a unilateral phaeochromocytoma in patients with MEN 2 syndrome, provided that they are carefully followed up.

• Authors: J S de Graaf, R P Dullaart, R P Zwierstra
• Journal: The European journal of surgery = Acta chirurgica (Eur J Surg) Vol. 165 Issue 9 Pg. 843-6 (Sep 1999) ISSN: 1102-4151 [Print] England
• PMID: 10533758 (Publication Type: Journal Article)

Topics

• Addison Disease (epidemiology, prevention & control)
• Adrenal Gland Neoplasms (surgery)
• Adrenalectomy (statistics & numerical data)
• Adult
• Female
• Follow-Up Studies
• Humans
• Male
• Multiple Endocrine Neoplasia Type 2a (surgery)
• Pheochromocytoma (surgery)
• Postoperative Complications (epidemiology, prevention & control)
• Time Factors