Early recognition of adrenal function deficit in patients undergoing multivisceral surgery including adrenalectomy for primitive retroperitoneal sarcomas
The extended multivisceral resection of retroperitoneum is the standard treatment for primary retroperitoneal soft tissue sarcomas. This procedure also includes the removal of the healthy adrenal gland ipsilateral to the tumor site. The investigators think that a such extended surgical approach together with the removal of the adrenal gland may lead to a state of acute adrenal insufficiency and related hemodynamic instability. In order to recognize this condition the investigators use a low dose ACTH test (Synacthen test) during the 1° and 10° post-operative days.
Study Type
OBSERVATIONAL
Enrollment
52
Fondazione IRCCS Istituto Nazionale dei Tumori
Milan, Lombardy, Italy
Serum Cortisol peak after low dose Synachten stimulation test.
Assessment of early postoperative acute adrenal dysfunction.
Time frame: 1st postoperative day
Serum Cortisol peak after low dose Synachten stimulation test.
Assessment of postoperative acute adrenal dysfunction.
Time frame: 10th postoperative day
Serum Cortisol peak after low dose Synachten stimulation test.
Assessment of postoperative chronic adrenal dysfunction.
Time frame: 4 months after surgery (only if test positive on 10th postoperative day)
Postoperative morbidity
Correlation between morbidity according to Clavien-Dindo and postoperative adrenal dysfunction
Time frame: 30th postoperative day
Vasoactive inotropic score
Correlation between intra- and postoperative usage of vasoactive drugs and postoperative adrenal dysfunction
Time frame: Intraoperatively and up to 3rd postoperative day
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