Flohr F, Seufert J
Abt. Innere Medizin II, Schwerpunkt Endokrinologie und Diabetologie, Universitätsklinikum Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
Internist (Berl). 2007 Jun;48(6):578-85. doi: 10.1007/s00108-007-1854-5.
Laparoscopic adrenalectomy and transsphenoidal pituitary surgery are currently established as the surgical procedures of choice with a low complication rate. Beyond potential surgical complications, one has to consider endocrine sequelae such as adrenal insufficiency and hypopituitarism. Without adequate endocrine treatment patients are prone to develop potentially lethal complications such as Addisonian crises or pituitary coma. Therefore, all patients should be seen by an endocrinologist before and after surgery. Patients with bilateral adrenalectomy require lifelong substitution of glucocorticoids and mineralocorticoids. Cushing's syndrome patients with unilateral adrenalectomy need temporary substitution. After pituitary surgery, all patients require functional assessment of their pituitary function, and, if necessary, adequate replacement therapy.
腹腔镜肾上腺切除术和经蝶窦垂体手术目前已成为并发症发生率低的首选手术方法。除了潜在的手术并发症外,还必须考虑内分泌后遗症,如肾上腺功能不全和垂体功能减退。如果没有适当的内分泌治疗,患者容易发生潜在致命的并发症,如肾上腺危象或垂体昏迷。因此,所有患者在手术前后都应由内分泌科医生诊治。双侧肾上腺切除术的患者需要终身补充糖皮质激素和盐皮质激素。单侧肾上腺切除术的库欣综合征患者需要临时补充。垂体手术后,所有患者都需要对垂体功能进行功能评估,必要时进行适当的替代治疗。