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Retroperitoneal adrenalectomy

Kodai Suzuki, Takahito Miyake, Hideshi Okada, Fuminori Yamaji, Yuichiro Kitagawa, Tetsuya Fukuta, Ryu Yasuda, Yoshihito Tanaka, Haruka Okamoto, Sho Nachi, Tomoaki Doi, Takahiro Yoshida, Keisuke Kumada, Shozo Yoshida, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura
BACKGROUND: Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management. CASE PRESENTATION: A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming...
June 23, 2017: Journal of Medical Case Reports
P Zonča, M Peteja, P Vávra, V Richter, P Ostruszka
INTRODUCTION: Minimally invasive adrenalectomy has become the gold standard for surgery of the suprarenal gland. Retroperitoneoscopic adrenalectomy with dorsal approach is preferred. The aim of our case report is to discuss potential complications that may arise from retroperitoneoscopic adrenalectomy, specifically an intra-operative injury of the inferior vena cava. CASE REPORT: A 47-year-old male patient was admitted to undergo elective adrenalectomy on the right side...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Magda Marek-Safiejko, Kamil Safiejko, Jerzy Łukaszewicz, Jacek Dadan, Robert J Ładny, Robert Kozłowski, Piotr Wojskowicz, Piotr Myśliwiec
BACKGROUND: Laparoscopic adrenalectomy is the gold standard for the surgical treatment of benign adrenal masses. It is most commonly performed using the lateral transperitoneal approach (LTA) and the posterior retroperitoneal approach (PRA). The choice of the method depends on contraindications for a particular approach in an individual case and surgical experience. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature review...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jay G Fuletra, Benjamin T Ristau, Barton Milestone, Harry S Cooper, Alysia Browne, Sujana Movva, Thomas J Galloway, Randall Lee, Nikhil Waingankar, Alexander Kutikov
Angiosarcoma of the adrenal gland is an extremely rare malignancy. We report a case of a 59-year-old female who presented with abdominal pain and profound anemia. A 7 cm enhancing, lipid-poor adrenal mass with calcifications that extended posterior to the vena cava was identified on imaging. Patient underwent right adrenalectomy with retroperitoneal lymph node dissection. Pathology demonstrated angiosarcoma of the adrenal gland. Consolidative treatment included adjuvant radiation and chemotherapy. Patient remains disease free 1...
January 2017: Urology Case Reports
O M Vrielink, K P Wevers, J W Kist, I H M Borel Rinkes, P H J Hemmer, M R Vriens, J de Vries, S Kruijff
PURPOSE: There has been an increased utilization of the posterior retroperitoneal approach (PRA) for adrenalectomy alongside the "classic" laparoscopic transabdominal technique (LTA). The aim of this study was to compare both procedures based on outcome variables at various ranges of tumor size. METHODS: A retrospective analysis was performed on 204 laparoscopic transabdominal (UMC Groningen) and 57 retroperitoneal (UMC Utrecht) adrenalectomies between 1998 and 2013...
August 2017: Langenbeck's Archives of Surgery
Thibaut Coste, Robert Caiazzo, Fanelly Torres, Marie Christine Vantyghem, Bruno Carnaille, François Pattou, Christine Do Cao, Claire Douillard
BACKGROUND: Laparoscopic adrenalectomy (LA) has become the standard technique for most indications. The aim of this study was to determine the predictive factors of intra- and postoperative complications in order to inform the orientation of patient to a surgeon with more experience in adrenal surgery. METHODS: From January 1994 to December 2013, 520 consecutive patients benefited from LA at Huriez Hospital, Lille, France. Each complication was graded according to the Dindo-Clavien-grade scale...
July 2017: Surgical Endoscopy
Shonan Sho, Michael W Yeh, Ning Li, Masha J Livhits
BACKGROUND: Endoscopic adrenalectomy is currently performed using multiple ports placed either transabdominally or retroperitoneally. We report our initial experience with single-incision retroperitoneoscopic adrenalectomy (SIRA). METHODS: A prospective database of patients undergoing adrenalectomy from December 2013 through March 2016 was analyzed. We adopted conventional retroperitoneoscopic adrenalectomy (CORA) in December 2013 and transitioned to SIRA in March 2015...
July 2017: Surgical Endoscopy
Jinhua Zi, Chao Ma, Changyun Xu, Yongli Bai
A 10 years old boy presented to our hospital complaining of belly pain. He had a retroperitoneal mass diagnosed by ultrasound 3 days before. During that time he was found to have slight hypertension. Computed tomography (CT) showed a left retroperitoneal mass with edge enhancement and central necrosis indicating pheochromocytoma (PCC). Vanillymandelic acid (VMA) in the 24 hours urine sample was not elevated. Pheochromocytoma was suspected given his hypertension and the ultrasound and CT findings. Fluorine-18- fluorodeoxy glucose positron emission tomography ((18)F-FDG PET) showed intense uptake in the left adrenal area (SUVmax 32...
September 2016: Hellenic Journal of Nuclear Medicine
Fuminori Sato, Ken Nakagawa, Akihiro Kawauchi, Akio Matsubara, Takatsugu Okegawa, Tomonori Habuchi, Koji Yoshimura, Akio Hoshi, Hidefumi Kinoshita, Akira Miyajima, Yasuyuki Naitoh, Shogo Inoue, Naoshi Itaya, Shintaro Narita, Kazuya Hanai, Kazutoshi Okubo, Masaaki Yanishi, Tadashi Matsuda, Toshiro Terachi, Hiromitsu Mimata
OBJECTIVE: To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan. METHODS: Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. RESULTS: Four hundred and sixty-nine cases were included in the analysis...
October 4, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
D Maccora, G V Walls, G P Sadler, R Mihai
INTRODUCTION The 2012 British Association of Endocrine and Thyroid Surgeons audit report showed that only 86 of 1359 patients who underwent adrenalectomy had a bilateral operation; thus the experience with this procedure remains limited. METHODS Retrospective review of patients undergoing bilateral adrenalectomy in a tertiary referral centre. RESULTS Between November 2005 and January 2016, bilateral adrenalectomy was performed in 23 patients (6 male, 17 female, age 43 ± 4 years) diagnosed with Cushing's disease (n = 13), hereditary phaeochromocytomas (n = 6), adrenocortical cancer (n = 2), colorectal metastatic disease (n = 1) and adrenocortical adenomas (n = 1)...
February 2017: Annals of the Royal College of Surgeons of England
Mark W Ball, Ashok K Hemal, Mohamad E Allaf
The aim of this study was to provide an evidence-based systematic review of the use of laparoscopic and robotic adrenalectomy in the treatment of adrenal disease as part of the International Consultation on Urological Diseases and European Association of Urology consultation on Minimally Invasive Surgery in Urology. A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined...
January 2017: BJU International
Marouene Chakroun, Waild Kerkeni, Yosra Zidi, Haroun Ayed, Abderrazak Bouzouita, Mohamed Riadh Ben Slama, Sihem Rammeh, Amine Derouiche, Mohamed Chebil
A 74-year-old man presented with right flank pain and a palpable mass in the left flank. Blood pressure was normal. Contrastenhanced computed tomography (CT) showed a 17 × 16 × 12 cm retroperitoneal mass over the left kidney, solid and heterogeneous. There were also 3 retro aortic lymph nodes and bilateral renal lithiasis. Twenty four-hour urinary metanephrines and normetanephrines were normal. The patient underwent a resection of the mass with left adrenalectomy by a lumbar incision. Histological findings revealed an adrenal oncocytic neoplasm (AON) with uncertain malignant potential...
September 2016: Urology Case Reports
Y Uehara, H Shimizu, K Ohtani, T Tsuchiya, H Takahashi, N Sato, Y Shimomura, M Mori
The activation of sympathetic activity which is related to hypothalamic corticotropin-releasing hormone (CRH) release may modulate ob gene expression in vivo. In the present studies, we determined changes in circulating leptin concentrations by modulating sympathetic activity by adrenalectomy, corticosterone supplement, hypothalamic CRH infusion and starvation in male Wistar rats. Bilateral adrenalectomy significantly inhibited serum leptin concentrations and the continuous supplement of corticosterone by silastic tube restored the reduction of serum leptin concentrations in adrenalectomized rats...
1998: Nutritional Neuroscience
Ajay V Maker, Vijay K Maker
INTRODUCTION: Minimally invasive adrenalectomy may be associated with reduction in postoperative pain, morbidity, and length of stay and, as a result, has become a preferred approach for many adrenal tumors. Left-sided adrenal tumors, however, are particularly challenging to address in the morbidly obese patient due to difficulties in maintaining exposure and dissection. The robotic platform offers instruments with greater degrees of freedom that aid in retraction and dissection, especially of the adrenal vein, but fixed patient positioning and the large distance needed between patient ports to avoid arm collisions can be restrictive in patients with a large amount of retroperitoneal fat and small working space...
February 2017: Surgical Endoscopy
Daniel A Wollin, Ganesh Sivarajan, Pratibha Shukla, Jonathan Melamed, William C Huang, Herbert Lepor
Retroperitoneal schwannoma is a rare tumor that is often misdiagnosed as malignancy due to a concerning appearance on cross-sectional imaging. Pathology and immunohistochemistry form the gold standard for diagnosis; as such, local excision is the treatment of choice for this disease. We present two cases of juxta-adrenal ancient schwannoma that were treated with adrenalectomy and discuss the current literature regarding this entity.
2015: Reviews in Urology
Amanda E Sautter, Steven C Cunningham, Gopal C Kowdley
Laparoscopic adrenalectomy is increasingly employed for removal of adrenal masses. As adrenal tumors increase in size, however, their malignant potential likewise increases, raising concerns for the use of laparoscopy for removal of large adrenal malignancies. We present a systematic review of the use of laparoscopic adrenalectomy of large malignant tumors. A PubMed search was undertaken and two independent reviewers reviewed the manuscripts and a methodological index for nonrandomized studies score was determined...
May 2016: American Surgeon
Radu Mihail Mirica, Octav Ginghina, Gabriela Zugravu, Razvan Iosifescu, Mihai Ionescu, Anca Ichiman, Adrian Rosca, Alexandra Mirica, Nicolae Iordache, Rubin Munteanu
INTRODUCTION: Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, which can derive from either parasympathetic or sympathetic paraganglia and are closely related to pheochromocytomas. CASE REPORT: We present the case of a young male patient of 37 years old, who was admitted for hypertensive crisis and palpitations. His medical history included medically controlled type 2 diabetes mellitus, (diagnosed 10 months ago), Hepatitis A...
March 2016: Chirurgia
Sandeep Singh Lubana, Navdeep Singh, Sandeep S Tuli, Barbara Seligman
BACKGROUND: Uterine papillary serous carcinoma (UPSC) is a highly malignant form of endometrial cancer with a high propensity for metastases and recurrences even when there is minimal or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, and peritoneum. However, adrenal metastases from UPSC is extremely rare. Here, we present a case of UPSC with adrenal metastasis that occurred 6 years after the initial diagnosis. CASE REPORT: A 60-year-old woman previously diagnosed with uterine papillary serous carcinoma at an outside facility presented in September of 2006 with postmenopausal bleeding...
April 27, 2016: American Journal of Case Reports
Weimin Yu, Ganpu Zhou, Fan Cheng, Ting Rao, Xiaobin Zhang, Huijun Qian, Stéphane Larré
The purpose of this study was to evaluate the safety and efficacy of the modified lateral transperitoneal (MLTP) approach in comparison with the traditional lateral transperitoneal (LTP) and lateral retroperitoneal (LRP) approach. From January 2008 to December 2012, 287 patients underwent laparoscopic adrenalectomy, and the MLTP, LTP and LRP approaches were used in 93, 96 and 98 patients. The patients' demographics and surgical outcomes from the three approaches were reviewed and compared. There were no significant differences in the general demographic or postoperative recovery variables among the three groups...
December 2015: Indian Journal of Surgery
Nicola Pavan, Riccardo Autorino, Hak Lee, Francesco Porpiglia, Yinghao Sun, Francesco Greco, S Jeff Chueh, Deok Hyun Han, Luca Cindolo, Matteo Ferro, Xiang Chen, Anibal Branco, Paolo Fornara, Chun-Hou Liao, Akira Miyajima, Iason Kyriazis, Marco Puglisi, Cristian Fiori, Bo Yang, Guo Fei, Vincenzo Altieri, Byong Chang Jeong, Francesco Berardinelli, Luigi Schips, Ottavio De Cobelli, Zhi Chen, Georges-Pascal Haber, Yao He, Mototsugu Oya, Evangelos Liatsikos, Luis Brandao, Benjamin Challacombe, Jihad Kaouk, Ithaar Darweesh
OBJECTIVE: To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. METHODS: A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML)...
October 2016: World Journal of Urology
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