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Laparoscopic adrenalectomy

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https://www.readbyqxmd.com/read/27903577/adrenal-cushing-syndrome-with-detectable-acth-from-an-unexpected-source
#1
Thinzar M Lwin, Nehal Galal, Shweta Gera, Jennifer L Marti
Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27888343/laparoscopic-anterior-versus-endoscopic-posterior-approach-for-adrenalectomy-a-shift-to-a-new-golden-standard
#2
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...
November 26, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#3
M Kotoulová, I Mikysková, J Dušková, J Vláčil, M Dvořák, M Halaška
OBJECTIVE: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus. DESIGNS: A case report. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. CASE REPORT: The authors report the case of a 33 year old woman, who was admitted to the clinic in 30th week of pregnancy for elevated blood pressure and hypokalemia...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27872977/hypertension-cure-following-laparoscopic-adrenalectomy-for-hyperaldosteronism-is-not-universal-trends-over-two-decades
#4
Takeshi Namekawa, Takanobu Utsumi, Tomoaki Tanaka, Mayuko Kaga, Hidekazu Nagano, Takashi Kono, Koji Kawamura, Naoto Kamiya, Takashi Imamoto, Hiroyoshi Suzuki, Tomohiko Ichikawa
BACKGROUND: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades. METHODS: This retrospective clinical study included 176 patients who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism from 1995 to 2015...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27867865/perioperative-hemodynamic-instability-in-patients-undergoing-laparoscopic-adrenalectomy-for-pheochromocytoma
#5
REVIEW
Magdalena Pisarska, Michał Pędziwiatr, Andrzej Budzyński
Perioperative hemodynamic instability still remains the biggest surgical and anesthetic challenge in surgery for pheochromocytoma. The aim of this review was to discuss pre-, intra- and postoperative factors that may impact on hemodynamic condition of a patient. It describes patients' preparation with appropriate medication, principles of surgical technique as well as risk factors for development of hemodynamic instability in postoperative period. Currently the gold standard in the treatment of pheochromocytoma is preoperative use of alpha-blockers and laparoscopic surgery...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27834023/laparoscopic-adrenalectomy-by-transabdominal-lateral-approach-20%C3%A2-years-of-experience
#6
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...
November 10, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27826779/single-incision-retroperitoneoscopic-adrenalectomy-a-north-american-experience
#7
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...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27819642/a-rare-complication-of-left-open-adrenalectomy
#8
Sanjay Kumar Yadav, Sapna Bothra, Aromal S Chekavar, Sabaretnam Mayilvaganan, Ashok Kumar Verma
Chyle leakage after left open adrenalectomy is a quite rare complication. We encountered a young male patient who was operated for left adrenal pheochromocytoma, left laparoscopic adrenalectomy converted to open due to dense adhesions. Postoperatively patient developed chylous fluid drainage on day 2. He was managed conservatively with high protein and MCT oil diet. This case highlights the unusual complication of left adrenalectomy surgery and how it can be managed.
2016: Chirurgia
https://www.readbyqxmd.com/read/27808580/recurrence-of-phaeochromocytoma-in-pregnancy-in-a-patient-with-multiple-endocrine-neoplasia-2a-a-case-report-and-review-of-literature
#9
Efterpi Tingi, Angelos Kyriacou, Lynda Verghese
Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant inherited condition with a prevalence of one in 40 000 individuals. It causes the development of tumours in endocrine glands, such as medullary thyroid cancer, pheochromocytomas, as well as primary hyperparathyroidism. MEN 2A in pregnancy is very rare with only 29 cases reported in the literature. The presence of pheochromocytoma is a rare cause of hypertension during pregnancy with an incidence of 0.007% of all pregnancies. This has severe implications on both mother and the foetus...
November 3, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27785436/laparoscopic-adrenalectomy-for-pheochromocytoma-does-size-matter-a-single-surgeon-comparative-study
#10
Niren Rao, Rashmi Ramachandran, Nikhil Tandon, Prabhjot Singh, Rajeev Kumar
BACKGROUND: Surgical difficulty in laparoscopic adrenalectomy for pheochromocytoma increases with tumor size. We compared single surgeon outcomes of laparoscopic adrenalectomy for pheochromocytomas in patients with tumors smaller or greater than 4 cm to assess safety of the procedure. METHODS: A retrospective review was performed of laparoscopic adrenalectomies for pheochromocytoma by a single surgeon over a 3-year period. All patients underwent lateral transperitoneal surgery...
October 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/27759750/pheochromocytoma-presenting-as-a-mimic-of-acute-coronary-syndrome
#11
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27758896/surgeon-authored-virtual-laparoscopic-adrenalectomy-module-is-judged-effective-and-preferred-over-traditional-teaching-tools
#12
Sergei Kurenov, Juan Cendan, Saleh Dindar, Kristopher Attwood, James Hassett, Ruth Nawotniak, Gregory Cherr, William G Cance, Jörg Peters
OBJECTIVE: The study assesses user acceptance and effectiveness of a surgeon-authored virtual reality (VR) training module authored by surgeons using the Toolkit for Illustration of Procedures in Surgery (TIPS). METHODS: Laparoscopic adrenalectomy was selected to test the TIPS framework on an unusual and complex procedure. No commercial simulation module exists to teach this procedure. A specialist surgeon authored the module, including force-feedback interactive simulation, and designed a quiz to test knowledge of the key procedural steps...
October 6, 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27752814/evaluating-the-learning-curve-for-retroperitoneoscopic-adrenalectomy-in-a-high-volume-center-for-laparoscopic-adrenal-surgery
#13
A van Uitert, F C H d'Ancona, J Deinum, H J L M Timmers, J F Langenhuijsen
BACKGROUND: Laparoscopic adrenalectomy is an effective method for benign adrenal tumor removal. In the literature, both lateral transperitoneal (TLA) and posterior retroperitoneoscopic (RPA) approaches are described. Since 2007, the number of patients increased significantly in our center. Therefore, RPA was introduced in 2011 because of its potential advantages in operating and recovery times. The learning curve of RPA is now evaluated. METHODS: All data of patients undergoing laparoscopic adrenalectomy from 2007 until 2014 were prospectively collected...
October 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27746437/somatostatin-secreting-pheochromocytoma-mimicking-insulin-dependent-diabetes-mellitus
#14
Hiroyuki Hirai, Sanae Midorikawa, Shinichi Suzuki, Hironobu Sasano, Tsuyoshi Watanabe, Hiroaki Satoh
We herein present the findings of a 42-year-old woman with either adrenal pheochromocytoma or intraadrenal paraganglioma that simultaneously secreted somatostatin, thus mimicking insulin-dependent diabetes mellitus. Pheochromocytoma was clinically diagnosed based on scintigraphy, elevated catecholamine levels, and finally a histopathological analysis of resected specimens. The patient had diabetic ketosis, requiring 40 U insulin for treatment. Following laparoscopic adrenalectomy, insulin therapy was discontinued and the urinary c-peptide levels changed from 5...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27743124/don-t-fix-it-if-it-isn-t-broken-a-survey-of-preparedness-for-practice-among-graduates-of-fellowship-council-accredited-fellowships
#15
Yusuke Watanabe, Amin Madani, Elif Bilgic, Katherine M McKendy, Gada Enani, Iman Ghaderi, Gerald M Fried, Liane S Feldman, Melina C Vassiliou
BACKGROUND: General surgery residency may not adequately prepare residents for independent practice. It is unclear; however, if non-ACGME-accredited fellowships are better meeting training needs. The purpose of this mixed-method study was to determine perceived preparedness for practice and to identify gaps in fellowship training. METHODS: A survey was developed using an iterative qualitative methodology based on interviews and focus groups of graduated fellows and program directors...
October 14, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27734531/laparoscopic-transperitoneal-adrenalectomy-in-morbidly-obese-patients-is-not-associated-with-worse-short-term-outcomes
#16
Michał Pędziwiatr, Piotr Major, Magdalena Pisarska, Michał Natkaniec, Magdalena Godlewska, Krzysztof Przęczek, Jadwiga Dworak, Marcin Dembiński, Anna Zub-Pokrowiecka, Andrzej Budzyński
OBJECTIVES: To evaluate the impact of obesity and morbid obesity on short-term outcomes after laparoscopic adrenalectomy. METHODS: The study included 520 consecutive patients undergoing laparoscopic adrenalectomy for adrenal tumor. The entire study group was divided depending on the body mass index: group 1 (normal weight), <25 kg/m(2) ; group 2 (overweight), 25-30 kg/m(2) ; and group 3 (obese) 30-40 kg/m(2) . Additionally, group 4 (morbidly obese) was distinguished...
October 12, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/27659055/laparoscopic-adrenalectomy-for-removal-of-unilateral-noninvasive-pheochromocytomas-in-10-dogs
#17
Kathryn A Pitt, Philipp D Mayhew, Michele A Steffey, William T N Culp, Mark C Fuller, Ann Della Maggiore, Richard W Nelson
OBJECTIVE: To report the surgical technique and outcome of dogs undergoing laparoscopic adrenalectomy for removal of unilateral noninvasive pheochromocytoma. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with unilateral noninvasive adrenal tumors (n=10). METHODS: Medical records of dogs that underwent laparoscopic adrenalectomy for histologically confirmed pheochromocytoma were reviewed. Dogs were positioned in lateral recumbency with the table tilted up to create a semi-sternal position...
November 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27642061/adrenal-surgery-for-oligometastatic-tumors-improves-survival-in-selected-cases
#18
P Tomasini, M-E Garcia, L Greillier, C Paladino, F Sebag, F Barlesi
INTRODUCTION: Oligometastatic cancer prognosis is distinct from polymetastatic cancer prognosis and surgery can improve survival. The objective of this study was to assess the role of adrenalectomy and to look for prognostic or predictive factors for the treatment of patients with oligometastatic solid tumors and adrenal metastasis. MATERIAL AND METHODS: Patients with oligometastatic solid tumors undergoing adrenalectomy were selected. Clinical data were retrieved from electronic patients records...
September 15, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27639794/surgical-and-hemodynamic-outcomes-in-pheochromocytoma-surgery-a-prospective-cohort-study
#19
Niren Rao, Rashmi Ramachandran, Nikhil Tandon, Prabhjot Singh, Rajeev Kumar
OBJECTIVE: To prospectively evaluate the surgical complications of pheochromocytoma and paraganglioma surgery and assess perioperative hemodynamic outcomes in terms of risk for intraoperative vasodilator use and risk for postoperative vasopressor requirements in these patients. PATIENTS AND METHODS: This was an institutional review board-approved prospective observational study of patients undergoing pheochromocytoma or paraganglioma surgery. Operative and recovery data for all patients undergoing open, laparoscopic, and robotic surgery were analyzed for surgical complications on the modified Clavien-Dindo classification...
September 14, 2016: Urology
https://www.readbyqxmd.com/read/27595615/tips-to-facilitate-a-preoperative-diagnosis-of-adrenal-ganglioneuroma-report-of-a-challenging-experience-and-review-of-the-literature
#20
Delia Proposito, Francesca De Lucia, Alessandra Giannella, Francesca Frangella, Giuseppe Pappalardo, Maria Santangelo, Domenico Magagnano
AIM: Ganglioneuroma (GN) is the most uncommon and the most benign tumor among neuroblastic neoplasms, and in 29.7% of cases it finds in an adrenal gland. Usually asymptomatic, this tumor is detected incidentally in the majority of cases. It is generally challenging to obtain a precise diagnosis of adrenal ganglioneuroma (AGN) before surgery. Misdiagnosis rate of AGN on CT and MRI is 64.7% and clinicians and surgeons are often lacking in knowledge of this rare disease. For this reason, we pointed out the clinical, biochemical, radiologic and pathologic features of AGN in an our experience, with the aim to find out if there are some features able to facilitate a preoperative diagnosis...
2016: Annali Italiani di Chirurgia
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