EUROCRINE®: Nebennierenoperationen 2015 bis 2019 – überraschende erste Ergebnisse [EUROCRINE®: adrenal surgery 2015-2019- surprising initial results]

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_E4D4AE56BD43
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
EUROCRINE®: Nebennierenoperationen 2015 bis 2019 – überraschende erste Ergebnisse [EUROCRINE®: adrenal surgery 2015-2019- surprising initial results]
Journal
Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
Author(s)
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., Triponez F., Trupka A., Wicke C., Musholt T.J.
ISSN
1433-0385 (Electronic)
ISSN-L
0009-4722
Publication state
Published
Issued date
18/09/2020
Peer-reviewed
Oui
Language
german
Notes
Publication types: English Abstract ; Journal Article
Publication Status: aheadofprint
Abstract
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.
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.
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.
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.
Keywords
Adrenal metastasis, Adrenalectomy, Adrenocortical carcinoma, EUROCRINE® registry, Laparoscopic adrenalectomy, Retroperitoneoscopic adrenalectomy
Pubmed
Web of science
Open Access
Yes
Create date
28/09/2020 11:52
Last modification date
23/10/2020 5:26
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