Adrenal insufficiency represents a debilitating condition which mandates lifelong steroid replacement and which is associated with significant long-term morbidity, due to either inadequate or excessive replacement. The concept of preserving healthy cortical tissue by means of partial adrenalectomy has evolved as a means of avoiding the detrimental consequences of adrenal insufficiency. The advent of advanced technology in adrenal surgery has greatly facilitated the performance of partial adrenalectomy, enabling utilization of this method in an increasing number of endocrine diseases. Hereditary pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, and non-functional adrenal masses represent the current indications for partial adrenalectomy, although the specific circumstances under which adrenal-sparing surgery should be proposed are still debatable. Partial adrenalectomy can be achieved by all types of minimally invasive surgery. In the absence of randomized, prospective, controlled studies designed to compare laparoscopic, retroperitoneoscopic, and robot-assisted partial adrenalectomy, none of these techniques has as yet been proven to be the gold standard for adrenal-sparing surgery. Apart from indications for surgery, results of surgery, and different types of partial adrenalectomy, controversial topics addressed in this review article include technical aspects such as the volume of residual adrenal tissue needed, ligation of adrenal vein, and means of tumor identification. Discussion of these controversial topics represents an attempt to define the role of partial adrenalectomy in modern adrenal surgery.

中文翻译：

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肾上腺保留手术：过去主题的最新概念。

肾上腺功能不全是一种使人衰弱的疾病，需要长期终生类固醇置换，并且由于置换不足或过多，会导致长期的高发病率。通过部分肾上腺切除术来保存健康的皮质组织的概念已经发展成为避免肾上腺功能不全的不利后果的一种手段。肾上腺外科手术中先进技术的出现极大地促进了部分肾上腺切除术的性能，使这种方法可用于越来越多的内分泌疾病中。遗传性嗜铬细胞瘤，康氏综合症，库欣氏综合症和无功能的肾上腺肿块代表了目前部分肾上腺切除术的适应症，尽管应该建议采取何种方法进行肾上腺保留手术仍有待商.。肾上腺部分切除术可以通过所有类型的微创手术来实现。在缺乏旨在比较腹腔镜，腹膜后镜和机器人辅助部分肾上腺切除术的随机，前瞻性，对照研究的情况下，这些技术尚未被证明是保留肾上腺手术的金标准。除了手术指征，手术结果和不同类型的肾上腺部分切除术外，本综述文章中涉及的有争议的主题还包括技术方面，例如所需的残余肾上腺组织量，肾上腺静脉的结扎和肿瘤的识别方法。