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KOMPLIKACIJE HIRURŠKOG LEČENJA NADBUBREŽNIH ŽLEZDA /

COMPLICATIONS OF SURGICAL TREATMENT OF ADRENAL GLANDS

Authors

 

Predrag Aleksić 1,2, Vladimir Bančević 1,2, Jovana Filipović 3

1Klinika za urologiju Vojnomedicinske Akademije, Beograd, Srbija
2Medicinski fakultet VMA, Univerzitet odbrane
3Sanitetska služba, Ministarstvo odbrane

 

UDK: 616.45-089-06(497.11)"2012/2016"


The paper was received / Rad primljen: 20.02.2020.

Accepted / Rad prihvaćen: 28.02.2020.

 


Correspondence to:


Vladimir Bančević,
Klinika za urologiju VMA,
Crnotravska 17, Beograd, Srbija;
e-mail: vladaban2004@yahoo.com

 

 

Sažetak

 

Uvod: Otvorene operacije nadbubrega i dalje imaju svoje mesto, naročito kod promena većih od 6 cm, kod pacijenata koji su imali ranije operacije u trbuhu, ili kod malignih promena nadbubrega. Metodologija: U kliničku retrospektivnu studiju je uključeno 50 pacijenata operisanih u petogodišnjem periodu od 2012-2016. godine u Klinici za urologiju VMA. Analizirani su životna dob, pol, lokalizacija i veličina odstranjene nadbubrežne žlezde, vreme operacije,  hirurški pristup, patohistološki nalaz kao i perioperativne komplikacije, a statističkim testovima je analizirana povezanost pojave komplikacija u zavisnosti od hirurškog pristupa i patohistološkog nalaza. Rezultati: Prosečna starost pacijenata je bila 51 (19-83) godine, 56% operisanih je bilo muškog pola, u 64% je odstranjena desna nadbubrežna žlezda, a u 86% operisanih pristup je bio lumbotomijski. Prosečne dimenzija odstranjenog nadbubrega su bile  59 (10-190) mm, a najčešći patohistološki nalaz u 50% slučajeva je bio adenom nadbubrega. Učestalost perioperativnih komplikacija je bila 14%, u 6% radilo se o povredi pleure a u po 4% su zabeležene povrede krvnih sudova i  infektivne komplikacije, kao najčešće. Nije dokazana statistička povezanost u javljanju komplikacija sa vrstom hirurškog pristupa, niti sa patohistološkim nalazom. Zaključak: Otvorena adrenalektomija je bezbedan hirurški pristup za lečenje tumora nadbubrega i većih dimenzija, svih etiologija sa malim procentom ozbiljnih komplikacija.

 

 

Ključne reči:

nadbubrežna žlezda, otvorena hirurgija, komplikacije

 

 

Abstract

 

Introduction: Open approach is still method of choice in adrenal surgery, especially in cases with adrenal volume larger than 6 cm, in patients who have had previous abdominal surgery, or with malignant adrenal changes. Methodology: A clinical retrospective study included 50 patients operated during  five-years period from 2012-2016. at the MMA Urology Clinic. Age, sex, localization and size of the removed adrenal gland, time of surgery, surgical approach, pathohistological findings as well as perioperative complications were analyzed, and statistical tests analyzed the correlation between the occurrence of complications depending on the surgical approach and pathohistological findings. Results: The mean age of the patients was 51 (19-83) years, 56% of the patients were male, the right adrenal gland was removed in 64%, and the approach was lumbotomy in 86% of the operated patients. The average dimension of the removed adrenal gland was 59 (10-190) mm, and the most common pathohistological finding in 50% of cases was adrenal adenoma. The incidence of perioperative complications was 14%, with 6% pleural iatrogenic injuries, and  4% of vascular injuries and infectious complications being reported  as the most commonly. No statistical association was found in the incidence of complications with the type of surgical approach, or with the histopathological findings. Conclusion: Open adrenalectomy is a safe surgical approach for the treatment of adrenal masses  and larger tumors of all etiologies with a small percentage of serious complications.

 

 

Key words:

Adrenal gland, open surgery, complications.

 

 

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PDF Aleksić P. et al • MD-Medical Data 2020;12(1): 007-010

 

 

 

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