endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg10233endoserg-10233Research ArticleОбзоры литературыReview of literatureПрогресс в хирургии надпочечников: дальнейшее расширение показаний к золотому стандарту леченияProgress in adrenal surgery: future widening of indications for the gold standard treatmenthttps://orcid.org/0000-0001-7669-0835ХрипунАлексей ИвановичKhripunAleksey I.

Доктор медицинских наук, профессор

MD, PhD, Professor

v.khabalonov@gmail.comhttps://orcid.org/0000-0002-2108-4587МахуоваГульмира БалтабековнаMakhuovaGulmira B.

Кандидат медицинских наук, доцент, заведующая 2 хирургическим отделением

PhD, Docent, chief of surgical department

gulmira1976@mail.ruhttps://orcid.org/0000-0002-9622-6789АвдееваТатьяна ФедеровнаAvdeevaTatyana F.

кандидат медицинских наук, врач-хирург

PhD, surgeon

v.khabalonov@gmail.comhttps://orcid.org/0000-0002-5552-3904ЮсуфовМагомед ПайзулаевичYusufovMagomed P.

Аспирант, врач-хирург

PhD student, surgeon

v.khabalonov@gmail.comРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияThe Russian National Research Medical University named after N.I. PirogovRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Городская клиническая больница им. В.М. БуяноваРоссияThe Russian National Research Medical University named after N.I. Pirogov; Moscow City Clinical Hospital named after V.M. BuyanovRussian FederationГородская клиническая больница имени В. М. БуяноваРоссияMoscow City Clinical Hospital named after V.M. BuyanovRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Городская клиническая больница им. В.М. БуяноваРоссияThe Russian National Research Medical University named after N.I. Pirogov; Moscow City Clinical Hospital named after V.M. BuyanovRussian Federation2019151020191326574Copyright © Хрипун А.И., Махуова Г.Б., Авдеева Т.Ф., Юсуфов М.П., 20192019Хрипун А.И., Махуова Г.Б., Авдеева Т.Ф., Юсуфов М.П.Khripun A.I., Makhuova G.B., Avdeeva T.F., Yusufov M.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/10233

Лапароскопическая адреналэктомия – признанный золотой стандарт хирургического лечения пациентов с патологией надпочечников. Ее преимущества по отношению к традиционным вмешательствам очевидно продемонстрированы накопленным опытом и определяют большую приверженность хирургов и пациентов методу. Однако и по настоящее время применение малоинвазивных вмешательств в определенных группах пациентов активно обсуждается в литературе. Наиболее актуальными остаются вопросы применения эндовидеохирургических технологий в лечении пациентов с крупными опухолями и злокачественными новообразованиями надпочечников. Объективно худшие хирургические показатели в этих группах, а также обеспокоенность относительно онкологических результатов определяют необходимость дальнейшего научного поиска. Настоящая статья посвящена современным достижениям в области хирургии надпочечников, связанным с внедрением и распространением эндовидеохирургических методов. В ней представлен системный обзор научной литературы, посвященный роли малоинвазивных вмешательств в хирургическом лечении пациентов с опухолями надпочечников. Особое внимание уделено существующим представлениям о показаниях и противопоказаниях к их применению. Проведен анализ осложнений эндоскопических операций, обсуждены пути их профилактики. Также затронута роль рентгенэндоваскулярных методов, в частности предоперационной эмболизации, в комплексном лечении пациентов с патологией надпочечников.

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.

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The authors declare that there are no conflicts of interest present.