Progress in adrenal surgery: future widening of indications for the gold standard treatment

Abstract

Laparoscopic adrenalectomy is regarded as a golden standard for surgical treatment of patients with adrenal pathology. Its advantages over the traditional surgery were shown by the experience and it explain commitment of surgeons to this method. However, implementation of this surgery is still discussible in some groups of the patients. Most relevant questions arouse about using laparoscopic technologies in patients with huge and malignant adrenal tumors. Objectively worse outcomes in these groups of patients and concerns about oncological results dictate need for future researches in this sphere. The article is devoted to the last achievements in adrenal surgery, connected with the implementation and wide spreading of laparoscopic operations. It covers most discussible in medical literature indications for such kind of surgery. Major attention is given to the modern concepts of indications and contraindications for laparoscopic procedures. A review of complications is done and we discuss ways of preventing them. Also, the article addresses to the role of endovascular embolization, in particular to the preoperative embolization, in complex treatment of patients with adrenal tumors.