Department of Digestive and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.
Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France.
Br J Surg. 2017 Mar;104(4):358-376. doi: 10.1002/bjs.10414.
Radical surgery provides the best chance of cure for adrenocortical carcinoma (ACC), but perioperative surgical care for these patients is yet to be standardized.
A working group appointed jointly by ENSAT and ESES used Delphi methodology to produce evidence-based recommendations for the perioperative surgical care of patients with ACC. Papers were retrieved from electronic databases. Evidence and recommendations were classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, and were discussed until consensus was reached within the group.
Twenty-five recommendations for the perioperative surgical care of patients with ACC were formulated. The quality of evidence is low owing to the rarity of the disease and the lack of prospective surgical trials. Multi-institutional prospective cohort studies and prospective RCTs are urgently needed and should be strongly encouraged.
The present evidence-based recommendations provide comprehensive advice on the optimal perioperative care for patients undergoing surgery for ACC.
根治性手术为肾上腺皮质癌（ACC）患者提供了最佳治愈机会，但这些患者的围手术期外科护理尚待标准化。
由 ENSAT 和 ESES 联合任命的工作组使用德尔菲法为 ACC 患者的围手术期外科护理制定了基于证据的建议。从电子数据库中检索论文。根据推荐评估、制定与评价分级（GRADE）系统对证据和建议进行分类，并在组内达成共识。
制定了 25 条关于 ACC 患者围手术期外科护理的建议。由于疾病罕见且缺乏前瞻性手术试验，证据质量较低。迫切需要并应强烈鼓励开展多机构前瞻性队列研究和前瞻性 RCT。
本循证建议为接受 ACC 手术的患者提供了最佳围手术期护理的全面建议。
