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adrenalectomy laparoscopic

Shogo Inoue, Testutaro Hayashi, Keisuke Hieda, Shunsuke Shinmei, Jun Teishima, Akio Matsubara
BACKGROUND/OBJECTIVE: To compare longitudinal patient-reported cosmesis of laparoendoscopic single-site adrenalectomy (LESS-A) to that of conventional laparoscopic adrenalectomy (CLA). METHODS: A total of 23, 15, and 9 patients underwent transumbilical LESS-A (TU-LESS), subcostal LESS-A (SC-LESS), and CLA, respectively. A questionnaire was administered asking the patient to assess wound pain (0: not painful to 10: very painful), satisfaction (0: not satisfied to 10: very satisfied), and cosmesis (0: very ugly to 10: very beautiful) on the basis of a visual analogue scale...
November 13, 2018: Asian Journal of Surgery
Koji Shiraishi, Seiji Kitahara, Hideaki Ito, Kazuo Oba, Chietaka Ohmi, Hideyasu Matsuyama
OBJECTIVES: To evaluate operative and oncological outcomes of laparoscopic adrenalectomy through a transperitoneal approach and retroperitoneal approach for large (>5 cm in diameter) pheochromocytomas. METHODS: We retrospectively compared the results of a transperitoneal approach with those of a retroperitoneal approach in 22 patients (mean age 57.5 years, range 38-76 years) with unilateral large pheochromocytomas (12 right, 10 left). The mean body mass index, operation time, pneumoperitoneum time, estimated blood loss, fluctuation in blood pressure and complication rate were compared between the two approaches...
November 14, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Maher Abdessater, Mohammad El Mokdad, Jerome Gas, Walid Sleiman, Patrick Coloby, Stephane Bart
INTRODUCTION: Retroperitoneal schwannomas (RS) are rare, benign tumors that originate in the neural sheath. Juxta-adrenal schwannomas may be misdiagnosed with giant adrenal tumors. This article reports the case of a RS that presented as an asymptomatic adrenal mass in a 50 Y.O female. PRESENTATION OF CASE: An abdominal ultrasound of our asymptomatic patient showed right adrenal lesion of 9 cm of diameter. Endocrinological evaluation was negative. The patient was considered to have a non-secreting right adrenal mass confirmed by adrenal scan...
October 15, 2018: International Journal of Surgery Case Reports
K Parmar, A Chandna, S Kumar
Retroperitoneal paragangliomas are rare tumours arising from neural crest cells located near or in the autonomic nervous system; right from the skull bass to the pelvic floor. Often called the great masqueraders, their diagnosis and treatment is often difficult and fraught with danger, considering the close proximity of these tumours to important retroperitoneal organs. A 29-year-old woman presented to the outpatient department with complaints of paroxysms of headache, sweating and palpitations for one year...
October 29, 2018: Annals of the Royal College of Surgeons of England
J Buxton, S H Vun, D van Dellen, R Wadsworth, T Augustine
OBJECTIVE: Adrenal surgery remains a distinct surgical challenge. Technical challenges associated with laparoscopic adrenalectomy are tumour size, haemorrhage control, and oncological compromise. Hand Assisted Laparoscopic (HAL) Adrenalectomy, utilising a hand-port device, offers minimally invasive surgery with the advantages and safety of tactile feedback. We aimed to assess the efficacy of HAL for patients requiring adrenalectomy for tumours over 5cm in size. CONTEXT: Hand assisted laparoscopic surgery is used in several surgical specialities over totally laparoscopic surgery to manage sizeable pathology, reduce operating time and conversion rates...
October 22, 2018: Clinical Endocrinology
Latika Gupta, Anusha S Bhatt, Varuna Mallya, Nita Khurana, Pawanindra Lal
Sporadic adrenal medullary hyperplasia (AMH) is a rare entity and mimics pheochromocytoma clinically as well as pharmacologically. It is characterized by increase in adrenal medullary cells with the expansion of cells into areas normally not seen. A 59-year-old male presented with chronic hypertension and raised 24-h urinary normetanephrine levels. Radiological and clinical possibility of pheochromocytoma led to left transperitoneal laparoscopic adrenalectomy. Histopathology, however, showed increase in adrenal medullary to cortical ratio, further confirmed by immunohistochemistry...
October 2018: Indian Journal of Pathology & Microbiology
Mateusz Wierdak, Grzegorz Sokołowski, Michał Natkaniec, Karolina Morawiec-Sławek, Piotr Małczak, Piotr Major, Alicja Hubalewska-Dydejczyk, Andrzej Budzyński, Michał Pędziwiatr
Introduction: The primary treatment of Conn's syndrome (CS) is laparoscopic adrenalectomy and aims to normalize arterial blood pressure and biochemical parameters. Aim: To analyse short- and long-term results of laparoscopic adrenalectomy for Conn's syndrome (CS). Material and methods: The analysis included 44 consecutive patients, who underwent laparoscopic adrenalectomy between 2004 and 2015 for CS. We analysed short- and long-terms results of operations...
September 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Ryszard Pogorzelski, Sadegh Toutounchi, Ewa Krajewska, Urszula Ambroziak, Łukasz Koperski, Tomasz Wołoszko, Krzysztof Celejewski, Małgorzata M Szostek, Wawrzyniec Jakuczun, Zbigniew Gałązka
Introduction: Adrenal cysts develop in up to about 0.2% of the overall population. They may account for up to 11% of all pathologies of adrenal glands. Aim: Is laparoscopic resection of adrenal cysts a method for the treatment of these pathologies? Material and methods: In the years 2010-2017, a total of 27 patients underwent surgery due to adrenal cysts; those included 18 (66.7%) women and 9 (33.3%) men aged 29 to 84 years (mean age: 42.7)...
September 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Sadegh Toutounchi, Ryszard Pogorzelski, Małgorzata E Legocka, Ewa Krajewska, Krzysztof Celejewski, Urszula Ambroziak, Zbigniew Gałązka
Introduction: Lateral transabdominal adrenalectomy (LTA) is the most common minimally invasive technique used to treat patients with adrenal tumors. Aim: To analyze intra-operative and post-operative complications and reasons for conversion to open surgery in patients who underwent LTA and had previous abdominal surgery. Material and methods: Five hundred and nineteen patients underwent LTA in our center between 2005 and 2016. We identified a study group of 150 patients, with previous abdominal surgery...
September 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Dong Wang, Han-Zhong Li, Yu-Shi Zhang, Liang Wang, Zhi-Gang Ji
OBJECTIVE: This study aimed to provide rational guidelines for patients with subclinical Cushing syndrome (SCS), who are undergoing laparoscopic adrenalectomy, in order to avoid the risk of overtreatment. METHODS: A total of 59 patients diagnosed with SCS caused by unilateral adrenal adenoma, who underwent laparoscopic adrenalectomy from 2010 to 2017, were included into the study. These patients did not receive prophylactic steroid treatment. After discharge, patients with adrenal insufficiency (AI) were treated with glucocorticoid...
October 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Wasita Warachit, Taywin Atikankul, Natnicha Houngngam, Sarat Sunthornyothin
Somatic KCNJ5 mutations result in excess aldosterone production and are reported to be more common in Asia than elsewhere. To assess the prevalence of somatic KCNJ5 mutations in Thai patients with aldosterone-producing adrenal adenomas (APAs) in a single tertiary center, we analyzed the paraffin-embedded tissue of KCNJ5 mutations from 96 patients with sporadic APAs who underwent unilateral laparoscopic adrenalectomy at our center during 2007 to 2016. We also assessed the clinical characteristics, treatment outcomes, and biochemistry and histologic differences among patients with and without somatic KCNJ5 mutations...
October 1, 2018: Journal of the Endocrine Society
Koji Hatano, Sayaka Horii, Yasutomo Nakai, Masashi Nakayama, Ken-Ichi Kakimoto, Kazuo Nishimura
AIM: We aimed to analyze surgical outcomes of open or laparoscopic adrenalectomy for solitary adrenal metastasis and assess the factors influencing survival. METHODS: We retrospectively reviewed our institutional clinicopathological database for cases of adrenalectomy for solitary adrenal metastasis from solid tumors between 2000 and 2017. RESULTS: Twenty-five patients underwent open adrenalectomy (n = 11) or laparoscopic adrenalectomy (n = 14)...
September 30, 2018: Asia-Pacific Journal of Clinical Oncology
Kan Wu, Zhihong Liu, Jiayu Liang, Yongquan Tang, Zijun Zou, Chuan Zhou, Fuxun Zhang, Yiping Lu
BACKGROUND: Open adrenalectomy is considered a standard operative approach for adrenocortical carcinoma, and laparoscopic adrenalectomy remains controversial. We analyzed our outcomes of laparoscopic adrenalectomy and open adrenalectomy for localized (stage 1/2) adrenocortical carcinoma in our hospital. METHODS: This study retrospectively reviewed all patients with stage 1/2 adrenocortical carcinoma and a tumor size < 10 cm who underwent radical resection in our hospital between 2009 and 2017...
September 26, 2018: Surgery
Pablo Quadri, Sofia Esposito, Adrian Coleoglou, Kirstie K Danielson, Mario Masrur, Pier C Giulianotti
INTRODUCTION: Laparoscopic adrenalectomy (LA) is accepted as the gold standard treatment for most adrenal pathologies. Open surgery is still considered the standard of care for large tumors and malignancies. In the past decade, robotic adrenalectomy (RA) has become an alternative to the laparoscopic and open approaches. The aim of this study was to analyze perioperative and postoperative outcomes in a series of consecutive nonselected patients undergoing a RA, to determine whether factors that negatively affect outcomes in LA (body mass index [BMI], size, and side of the tumor) have the same impact in RA...
September 28, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
W F Young
Primary aldosteronism (PA), the most common form of secondary hypertension, can be either surgically cured or treated with targeted pharmacotherapy. PA is frequently undiagnosed and untreated, leading to aldosterone-specific cardiovascular morbidity and nephrotoxicity. Thus, clinicians should perform case detection testing for PA at least once in all patients with hypertension. Confirmatory testing is indicated in most patients with positive case detection testing results. The next step is to determine whether patients with confirmed PA have a disease that can be cured with surgery or whether it should be treated medically; this step is guided by computed tomography scan of the adrenal glands and adrenal venous sampling...
September 25, 2018: Journal of Internal Medicine
Paxton V Dickson, Lawrence Kim, Tina W F Yen, Anthony Yang, Elizabeth G Grubbs, Dhavel Patel, Carmen C Solórzano
This is the first of a two-part review on adrenocortical carcinoma (ACC), a rare and aggressive malignancy that often presents at an advanced stage. Most patients present with symptoms related to cortisol and/or androgen excess. Appropriate biochemical evaluation and imaging is important in assessing the extent of disease, operative planning, and oncologic surveillance for patients with ACC. For patients with locoregional disease, potential cure requires margin-negative resection, and accumulating evidence suggests that regional lymphadenectomy should be performed...
September 18, 2018: Annals of Surgical Oncology
Valerio Panizzo, Barbara Rubino, Guglielmo Niccolò Piozzi, Paolo Ubiali, Anna Morandi, Marco Nencioni, Giancarlo Micheletto
BACKGROUND Adrenocortical oncocytic neoplasms (AONs) are extremely rare tumors. AONs are classified as: oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP), and oncocytic carcinoma (AOC). Among the 162 reported cases of AONs in the literature, 30 cases were classified as malignant. Adrenalectomy is the treatment of choice for AON. CASE REPORT We report the case of a 48-year-old man with a primitive 12-cm mass affecting the right adrenal gland, detected by ultrasonography during follow-up for alcoholic liver cirrhosis...
September 15, 2018: American Journal of Case Reports
Liang Zhou, Xiang Pan, Tao He, Yulin Lai, Wenhua Li, Yiming Hu, Liangchao Ni, Shangqi Yang, Yun Chen, Yongqing Lai
Primary adrenal teratoma is a rare type of cancer. Of the 338 patients who underwent adrenalectomy during this study, only 2 (aged 69 and 29 years) were diagnosed with adrenal teratoma and underwent laparoscopic retroperitoneal adrenalectomy. For the purposes of the present study, the term 'adrenal teratoma' was searched in the PubMed database, and 237 articles published between June 1952 and March 2017 were retrieved. However, we were only able to identify 10 relevant studies. In total, these studies reported a series of 18 cases of primary adrenal teratoma in patients aged >16 years, another 8 cases of adult adrenal retroperitoneal teratoma, and 7 cases of adrenal teratoma in children aged <16 years...
October 2018: Molecular and Clinical Oncology
Kirtishri Mishra, Matthew J Maurice, Laura Bukavina, Robert Abouassaly
OBJECTIVES: To evaluate whether the technical advantages of robotic-assisted surgery over standard laparoscopy, which are well established for complex renal surgery, lead to variable surgical outcomes between laparoscopic adrenalectomy (LA) and robotic adrenalectomy (RA). METHODS: Using the National Cancer Database, we identified patients who underwent LA or RA for non-metastatic primary adrenal malignancy from 2010-2013. Primary outcomes were need for open conversion, surgical margin status, and performance of regional lymphadenectomy...
September 6, 2018: Urology
Michał Aporowicz, Paweł Domosławski, Piotr Czopnik, Krzysztof Sutkowski, Krzysztof Kaliszewski
Introduction: The perioperative complication rate of adrenalectomy varies between 1.7% and 30.7% in the medical literature. This study presents outcomes of adrenalectomy in our center and tries to point out risk factors for perioperative problems. Material and methods: We retrospectively analyzed all patients who underwent adrenalectomy in our department from January 2004 to June 2015. Patient's sex, indication for procedure, tumor laterality, surgical approach and surgeon's case volume were taken into consideration as possible risk factors for complications...
August 2018: Archives of Medical Science: AMS
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