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adrenalectomy laparoscopic

Fukang Sun, Ran Zhuo, Wenming Ma, Hongchao He, Lei Ye, Danfeng Xu, Weiqing Wang, Guang Ning
BACKGROUND AND OBJECTIVES: To clarify the correlation of variant venous anatomy with adrenal tumor phenotype and surgical outcomes. PATIENTS AND METHODS: This retrospective study included 303 consecutive minimally invasive adrenalectomies from 301 patients. All adrenal veins were identified. We compared the preoperative, intraoperative, and postoperative data between patients with and without variant adrenal venous anatomy. We also explored the factors associated with venous variants...
January 30, 2019: Journal of Surgical Oncology
H H Chen, S T Wu, Y C Lin, C S Lin
We report a 49-year-old woman who presented with a hypertensive crisis and acute heart failure and reduced left ventricular systolic function. An abdominal ultrasonography revealed a huge lobulated heterogeneous mass at the lower pole of the right kidney and a mass over the left suprarenal area, which were further delineated by magnetic resonance imaging. The patient underwent laparoscopic right radical nephrectomy and left adrenalectomy. Histopathological analysis confirmed the diagnoses of clear cell renal cell carcinoma of the right kidney with metastasis to the lung; and atypical pheochromocytoma of the left adrenal gland...
January 2019: Journal of Postgraduate Medicine
Masashi Kato, Akihiko Murata, Shinsuke Nishikawa, Shinji Tsutsumi, Kensuke Okano, Yoichi Yamauchi, Motonari Ohashi, Akitoshi Kimura, Minoru Umehara, Naoki Hashimoto, Yutaka Umehara, Kenichi Takahashi
A 70-year-old woman had consulted a doctor at a former clinic because of bloody stool and colonoscopy revealed a type 2 tumor of the rectum. She was referred to our hospital for further examinations and treatment. Preoperative blood examination showed an elevated HbA1c level of 10.2%. Abdominal CT showed a 25mm tumor in the left adrenal gland. The patient was diagnosed with adrenal Cushing's syndrome based on low ACTH levels, disappearance of circadian variation in blood cortisol levels, lack of inhibition by dexamethasone loading, and high urinary cortisol levels...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
John W Funder
Primary aldosteronism (PA), currently recognized to be 5-10% of hypertension, has a cardiovascular risk profile double that in age-, sex-, and blood pressure-matched essential hypertensives. Screening for PA is by determining the plasma aldosterone to renin ratio (ARR), followed by one of half a dozen confirmatory/exclusion tests. Unilateral hyperaldosteronism normally reflects an aldosterone producing adenoma; bilateral disease is the more common form, and termed idiopathic hyperaldosteronism (IHA). Subjects confirmed undergo imaging, followed by adrenal venous sampling (AVS) for lateralization...
2019: Vitamins and Hormones
Andrea Balla, Monica Ortenzi, Livia Palmieri, Diletta Corallino, Francesca Meoli, Pietro Ursi, Giulia Puliani, Emilia Sbardella, Andrea M Isidori, Mario Guerrieri, Silvia Quaresima, Alessandro M Paganini
BACKGROUND: The aim of this study is to evaluate the feasibility, safety, advantages and surgical outcomes of laparoscopic bilateral adrenalectomy (LBA) by an anterior transperitoneal approach. METHODS: From 1994 to 2018, 552 patients underwent laparoscopic adrenalectomy, unilateral in 531 and bilateral in 21 patients (9 females and 12 males). All patients who underwent LBA were approached via a transperitoneal anterior route and form our study population. Indications included: Cushing's disease (n = 11), pheochromocytoma (n = 6), Conn's disease (n = 3) and adrenal cysts (n = 1)...
January 23, 2019: Surgical Endoscopy
Monica Ortenzi, Andrea Balla, Roberto Ghiselli, Roberto Vergari, Gianfranco Silecchia, Emanuele Guerrieri, Alessandro Maria Paganini, Mario Guerrieri
INTRODUCTION: The combination of Cushing's syndrome and obesity, one of the most common manifestations of the syndrome itself, may be associated with the worsening of post-operative outcomes in case of laparoscopic adrenalectomy. This study focused on the laparoscopic treatment of Cushing's syndrome with the purpose to identify any relevant difference between morbidly obese, mildly obese and non-obese patients. MATERIAL AND METHODS: Patients were retrospectively divided into three groups according to their Body Mass Index (BMI)...
January 19, 2019: Minimally Invasive Therapy & Allied Technologies: MITAT
Bruna Babic, Amory De Roulet, Anita Volpe, Naris Nilubol
Background: Patients with Cushing syndrome (CS) have an increased risk for venous thromboembolism (VTE). However, it is unclear whether patients undergoing adrenalectomy for CS are at increased risk for postoperative VTE. The aim of this study was to determine the rate of postoperative VTE in patients undergoing adrenalectomy for CS. Methods: A retrospective analysis of patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent adrenalectomy from 2005 to 2016 was performed...
February 1, 2019: Journal of the Endocrine Society
Jason Ramsingh, Patrick O'Dwyer, Carol Watson
BACKGROUND: Adrenal metastases can arise from different primary sites. Surgical resection of the adrenal gland in patients with isolated metastases may offer improved survival in many of these patients. However, the benefit of surgery in this heterogenous group is often disputed. The aim of this study was to identify patients undergoing adrenalectomy for isolated metastases and to describe survival outcomes based on origin of the primary malignancy. METHODS: Patients undergoing surgery for isolated adrenal metastases were retrospectively analysed from a prospectively kept database...
January 4, 2019: European Journal of Surgical Oncology
Ankush Sarwal, Rajesh Khullar, Anil Sharma, Vandana Soni, Manish Baijal, Pradeep Chowbey
Adrenal incidentaloma (AI) has now become a common finding in clinical practice with advances in abdominal imaging. The prevalence of AI as reported in the literature is 0.2%-3%. Ganglioneuroma (GN) is often a benign non-functioning adrenal tumour, which has been rarely reported as AI in literature. Confirmed diagnosis of GN can only be done by histopathological examination. GNs are often asymptomatic even if they are large, and adrenalectomy is treatment for GN, with good prognosis after surgical removal. Here, we report a patient with an incidental adrenal mass that was managed laparoscopically and diagnosed as an adrenal GN on histopathology...
January 4, 2019: Journal of Minimal Access Surgery
Orhan Agcaoglu, Berke Sengun, Kazim Senol, Bulent Gurbuz, Emre Ozoran, Senol Carilli, Serdar Tezelman
To date, the single-incision laparoscopic surgery (SILS) technique has been applied to a wide range of general surgical procedures; however, there are still scant data and debates on adrenal procedures. The aim of this study was to compare surgical outcomes of single-incision versus laparoscopic multiport adrenalectomy. The patients were divided into 2 study groups on the basis of the surgical approach: SILS (group 1) and multiport laparoscopic surgery (group 2). Patient demographics and their perioperative and postoperative results were evaluated retrospectively from the medical records...
December 1, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Hyoung Nam Lee, Sung Gi Cho, Woong Hee Lee
Hepatic compartment syndrome is an increase in intrahepatic pressure sufficient to cause compromised hepatic perfusion. Early recognition and prompt management are essential for preventing catastrophic consequences including ischemic liver failure and hypovolemic shock. This is the rare case of laparoscopic adrenalectomy resulting in subcapsular hepatic hematoma with hepatic compartment syndrome. Contrast-enhanced computed tomography demonstrated extensive subcapsular hepatic hematoma with collapse of portal vein and inferior vena cava suggesting impending compartment syndrome...
January 2, 2019: Cardiovascular and Interventional Radiology
Alberto Arezzo, Alberto Bullano, Giovanni Cochetti, Roberto Cirocchi, Justus Randolph, Ettore Mearini, Andrea Evangelista, Giovannino Ciccone, H Jaap Bonjer, Mario Morino
BACKGROUND: Laparoscopic adrenalectomy is an accepted treatment worldwide for adrenal gland disease in adults. The transperitoneal approach is more common. The retroperitoneal approach may be preferred, to avoid entering the peritoneum, but no clear advantage has been demonstrated so far. OBJECTIVES: To assess the effects of laparoscopic transperitoneal adrenalectomy (LTPA) versus laparoscopic retroperitoneal adrenalectomy (LRPA) for adrenal tumours in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, ICTRP Search Portal, and ClinicalTrials...
December 30, 2018: Cochrane Database of Systematic Reviews
Frederick Thurston Drake, Toni Beninato, Maggie X Xiong, Nirav V Shah, Wouter P Kluijfhout, Timothy Feeney, Insoo Suh, Jessica E Gosnell, Wen T Shen, Quan-Yang Duh
BACKGROUND: Several malignancies metastasize to the adrenal gland, especially non-small cell lung cancer, renal cell carcinoma, and melanoma. Adrenalectomy is associated with prolonged survival, but laparoscopic adrenalectomy for this indication is controversial. Our objective was to characterize and quantify outcomes after laparoscopic adrenalectomy for metastases to the adrenal gland. METHODS: A prospectively maintained surgical database and institutional cancer registry were queried for patients who underwent adrenalectomy for metastases...
December 24, 2018: Surgery
Umberto Maestroni, Simona Cataldo, Valentina Moretti, Marco Baciarello, Giada Maspero, Francesco Ziglioli
Introduction: Laparoscopic adrenalectomy is a treatment option in patients with Cushing's syndrome. Preoperative comorbities as well as surgical and anesthesiological difficulties can make the procedure challenging. Presentation of the case: We present the case of a 53-year-old obese man diagnosed with Cushing's syndrome, also suffering from other endocrine pathologies, neurofibromatosis type 2, cardiomiopathy with severe hypertrophy and diastolic dysfunction, deep vein thrombosis (DVT) and obstructive sleep apnea syndrome (OSAS)...
December 2018: Annals of Medicine and Surgery
I A Kurganov, S I Emelyanov, D Yu Bogdanov, N L Matveev, A V Fedorov, G M Rutenburg, A B Guslev
AIM: To study surgical features of laparoscopic adrenalectomy in patients with large adrenal neoplasms. MATERIAL AND METHODS: The results of 32 laparoscopic adrenalectomy procedures were analyzed in patients with adrenal neoplasms over 5 cm. The control group consisted of 67 patients with adrenal neoplasms up to 5 cm. RESULTS: There were significant differences in duration of operations (96.3±13.44 min vs. 67.2±11.07 min; p<0.05) and some postoperative variables...
2018: Khirurgiia
Dadhija Ramlagun, Kamleshsingh Shadhu, Miaomiao Sang, Kai Zhu, Chao Qin, Min Sun
RATIONALE: Primary aldosteronism due to aldosteronoma is the most common form of secondary hypertension, with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Diagnosis is a clinical challenge with simultaneous occurrence of primary ectopic meningioma in the adrenal gland. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronomas and ectopic meningioma in the adrenal gland based on literatures...
December 2018: Medicine (Baltimore)
Yoko Koh, Toshihisa Asakura, Kinzo Katayama, Norihide Tei, Yasunori Harada, Kensaku Nishimura
A 69-year-old woman was admitted to the previous hospital because of a right adrenal tumor detected by a medical checkup. Although the tumor was diagnosed as non-functional adrenal adenoma, abdominal computed tomography (CT) revealed a left renal mass which was suspected to be renal cell carcinoma. Chest CT seeking for metastatic lesions revealed lung cancer of the left lung. First, laparoscopic radical nephrectomy was performed. After the surgery, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) CT performed for staging of the lung cancer demonstrated FDG uptake to the left lung mass, the heart, the right adrenal mass and perirenal regions of the right kidney...
November 2018: Hinyokika Kiyo. Acta Urologica Japonica
Radosław Samsel, Andrzej Cichocki, Katarzyna Roszkowska-Purska, Sławomir Falkowski
Primary adrenal leiomyosarcomas are very rare adrenal mesenchymal tumours, only few dozen has been reported in the English language literature so far. We present two cases of patients with primary adrenal leiomyoosarcomas. 80 year-old female admitted with left adrenal tumour with presumptive diagnosis of nonadenoma, laparoscopic adrenalectomy was performed and 85 year-old man who underwent surgical resection by laparotomy of adrenal tumour suspected for adrenal carcinoma. Native density on unenhanced CT was 30 (HU) and 28 (HU) respectively and absolute and relative contrast washout was non-characteristic...
November 28, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Song Bai, Zichuan Yao, Xianqing Zhu, Zidong Li, Yunzhong Jiang, Rongzhi Wang, Bin Wu
BACKGROUND: Surgical resection is the main treatment strategy for pheochromocytoma. Whether laparoscopic techniques are feasible for large pheochromocytoma treatments is controversial. The aim of this study was to evaluate the feasibility and safety of transperitoneal laparoscopic adrenalectomy (LA) compared with open adrenalectomy (OA). METHODS: We retrospectively studied 182 patients with radiographic tumor sizes ≥ 6 cm who underwent adrenalectomy at our center between 1 January 2007 and 31 December 2017...
November 29, 2018: International Journal of Surgery
Brenessa Lindeman, Atul A Gawande, Francis D Moore, Nancy L Cho, Gerard M Doherty, Matthew A Nehs
BACKGROUND: Objective criteria are lacking to determine whether a laparoscopic transabdominal (LA) or retroperitoneoscopic (RP) approach to adrenalectomy is optimal. We hypothesized that imaging characteristics could predict patients for whom RP adrenalectomy is the optimal approach. MATERIALS AND METHODS: Retrospective cohort study of all patients undergoing minimally invasive adrenalectomy between 2014 and 2016 (n = 113) at one institution. Imaging measurements included distances between the skin and Gerota's fascia (S-GF), upper borders of adrenal and kidney (A-K), adrenal and 12th rib (A-R), 12th rib and iliac crest (R-IC), and perinephric fat (PNF)...
January 2019: Journal of Surgical Research
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