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Laparoscopic adrenalectomy

Chrysanthi Aggeli, Alexander M Nixon, Christos Parianos, Georgios Vletsis, Labrini Papanastasiou, Theodora Kounadi, Georgrios Piaditis, Georgios N Zografos
OBJECTIVE: Resection of pheochromocytomas is a challenging procedure due to hemodynamic lability. Our aim was to evaluate surgical outcomes in 67 patients with pheochromocytoma and to validate the role of laparoscopic surgery in the treatment of these tumors. DESIGN: This study is a retrospective review. A total of 68 procedures for pheochromocytoma were performed between June 1997 and February 2017. All patients were investigated and operated on using an established departmental protocol...
October 2017: Hormones: International Journal of Endocrinology and Metabolism
Kuo-How Huang, Chih-Chin Yu, Ya-Hui Hu, Chin-Chen Chang, Chieh-Kai Chan, Shih-Cheng Liao, Yao-Chou Tsai, Shih-Chieh Jeff Chueh, Vin-Cent Wu, Yen-Hung Lin
BACKGROUND/PURPOSE: Even with the increasing recognition of primary aldosteronism (PA) as a cause of refractory hypertension and an issue of public health, the consensus of its optimal surgical or medical treatment in Taiwan has not been reached. Our objective was to develop a clinical practice guideline that is feasible for real-world management of PA patients in Taiwan. METHODS: The Taiwan Society of Aldosteronism (TSA) Task Force recognized the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics and constraints into PA management...
March 2, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Yutaka Endo, Minoru Kitago, Akira Miyajima, Isao Kurihara, Kaori Kameyama, Masahiro Shinoda, Hiroshi Yagi, Yuta Abe, Taizo Hibi, Chisato Takagi, Yutaka Nakano, Wataru Koizumi, Osamu Itano, Yuko Kitagawa
INTRODUCTION: von Hippel-Lindau disease (vHL disease) is a hereditary disease in which tumors and cysts develop in many organs, in association with central nervous system hemangioblastomas, pheochromocytomas, and pancreatic tumors. We herein report a case of vHL disease (type 2A) associated with bilateral pheochromocytomas, pancreatic neuroendocrine tumors (PNET), and cerebellar hemangioblastomas treated via pancreatectomy after adrenalectomy. CASE PRESENTATION: A 51-year-old woman presented with a cerebellar tumor, bilateral hypernephroma, and pancreatic tumor detected during a medical checkup...
February 16, 2018: International Journal of Surgery Case Reports
O M Vrielink, A F Engelsman, P H J Hemmer, J de Vries, W M C M Vorselaars, M R Vriens, A Karakatsanis, P Hellman, M S Sywak, B L van Leeuwen, M El Moumni, S Kruijff
BACKGROUND: Posterior retroperitoneoscopic adrenalectomy has gained international popularity in the past decade. Despite major advantages, including shorter duration of operation, minimal blood loss and decreased postoperative pain, many surgeons still prefer laparoscopic transperitoneal adrenalectomy. It is likely that the unfamiliar anatomical environment, smaller working space and long learning curve impede implementation. The present study assessed the number of procedures required to fulfil the surgical learning curve for posterior retroperitoneoscopic adrenalectomy...
March 1, 2018: British Journal of Surgery
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, Hamy Antoine, O Larin, O Tovkay, S Cherenko
BACKGROUND: Pheochromocytoma (PHEO) in pregnancy is a life-threatening condition. Its management is challenging with regards to the timing and type of surgery. METHODS: A retrospective review of the management of ten patients diagnosed with pheochromocytoma during pregnancy was performed. Data were collected on the initial diagnostic workup, symptoms, treatment, and follow-up. RESULTS: PHEO was diagnosed in ten patients who were between the 10th and the 29th weeks of pregnancy...
February 27, 2018: Surgical Endoscopy
Ho Seok Chung, Myung Soo Kim, Ho Song Yu, Eu Chang Hwang, Sun-Ouck Kim, Kyung Jin Oh, Seung Il Jung, Taek Won Kang, Kwangsung Park, Dong Deuk Kwon
OBJECTIVES: To evaluate the surgical feasibility of laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of large pheochromocytomas, and to identify the preoperative risk factors for intraoperative hypertension. METHODS: We retrospectively reviewed 51 patients who underwent laparoscopic adrenalectomy using the lateral retroperitoneal approach for the treatment of pheochromocytomas. Patient characteristics and perioperative outcomes were analyzed and compared between the two study groups based on tumor size: group A (n = 27, ≤6 cm) and group B (n = 24, ˃6 cm)...
February 25, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
D Nikoleishvili, G Koberidze, M Kutateladze, G Zumbadze, A Mariamidze
Adrenocortical carcinoma is a very rare and aggressive endocrinological malignancy arising from the adrenal cortex. The estimated incidence is 1 per million people, with an estimated 5-year survival rate of 16-47%. It can be bilateral in roughly 2-10% of cases, but the data is scarce and there is no conclusive evidence whether the contralateral mass is an independent tumor or a metastasis from the other adrenal gland cancer. Radical surgical excision is the only curative treatment. Therefore, careful pre- and intraoperative surgical planning is critically important...
January 2018: Georgian Medical News
Binbin Gong, Ming Ma, Wenjie Xie, Xiaorong Yang, Ting Sun
OBJECTIVES: To analyze our experience in retroperitoneal laparoscopic adrenalectomy (RLA) with transient renal artery occlusion for large adrenal tumors (≥8 cm) and to explore the safety and feasibility of this surgical procedure. METHODS: A retrospective cohort study was conducted with a surgical data review of 18 patients with large adrenal tumors who underwent RLA with transient renal artery occlusion in our hospital. RESULTS: Eighteen patients were treated by RLA with transient occlusion of the renal artery, and none were converted to open adrenalectomy...
February 15, 2018: Journal of Surgical Oncology
Maryam K Al Badi, Ibrahim Al-Alwan, Mohammed Al-Dubayee, Ayed Al-Anzi, Maram S Al Turki, Noura Aloudah, Khaled O Alsaad
Oncocytic tumors are epithelial neoplasms that occur in various organs, including adrenal glands. Oncocytic adrenocortical adenomas and carcinomas are uncommon but well-known pathological entities in adults. However, generally oncocytic tumors, particularly in the adrenal glands, are very rare in the pediatric age-group. Most oncocytic adrenal tumors are not functional. We present a rare case of right-sided, functional oncocytic adrenocortical adenoma in a 5-year-old boy, who presented with clinical manifestations of precocious puberty and Cushing syndrome...
January 1, 2018: Pediatric and Developmental Pathology
Felipe de Almeida E Paula, Ravisio Israel Dos Santos, Odivaldo Antonio Ferruzzi, Rafael Osti Melo, Mariana Takaku
A 32-year-old 22-week pregnant hypertensive woman with sporadic episodes of headaches, sweating, and facial flushing was diagnosed with pheochromocytoma through biochemical and imaging tests. Perioperative management included a multidisciplinary approach, symptom stabilization with ɑ blockade followed by β blockade, and tumor resection by laparoscopic adrenalectomy at 24 weeks gestation. The diagnosis was confirmed by histopathological examination and immunohistochemistry tests. The decision for surgical removal of the tumor was based on maternal symptoms, tumor size, gestational age, the possibility of doing a laparoscopy, and the expertise of the surgical team...
February 8, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Martin K Walz, Laura D Iova, Judith Deimel, Hartmut P H Neumann, Birke Bausch, Stefan Zschiedrich, Harald Groeben, Pier F Alesina
BACKGROUND: Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access. MATERIALS: In the setting of a prospective study (1/2001-12/2016), 42 consecutive children and adolescents (33 m, 9 f) were operated on...
February 1, 2018: World Journal of Surgery
Hung-Cheng Kan, See-Tong Pang, Chun-Te Wu, Ying-Hsu Chang, Chung-Yi Liu, Cheng-Keng Chuang, Po-Hung Lin
RATIONALE: Laparoscopic adrenalectomy is currently the standard of care for adrenal lesion. Minimal invasive laparoscopic surgery such as laparoendoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) have been developed to improve cosmetic outcomes and reduce postoperative pain. However, there are still some problems related to instruments and port limitation during LESS surgery. Robot-assisted laparoscopic surgery may help to overcome these problems, and port platforms selection is an important issue...
December 2017: Medicine (Baltimore)
Zuliang Feng, Michael P Feng, David P Feng, Mark J Rice, Carmen C Solórzano
In recent years, the use of robotic-assisted adrenalectomy (RA) has increased; however, many surgeons question its reported higher cost. In this study, we review our experience and strategies to reduce the cost of RA comparing it to Laparoscopic adrenalectomy (LA). Since May of 2010, 122 consecutive patients underwent minimally invasive adrenalectomy (58 RAs and 64 LA) by a high-volume adrenal surgeon at our institution. A cost analysis was performed for RA versus LA. Cost calculations included anesthesia professional fee, procedure time and consumables fees...
January 31, 2018: Journal of Robotic Surgery
Jing Xie, Jun Dai, Wen-Long Zhou, Fu-Kang Sun
BACKGROUND: Adrenal ganglioneuromas (AGNs) are extremely rare benign neoplasms. This study is to share our experience regarding diagnostic and operative management of these tumors. METHODS: Clinical details as well as follow-up data were retrospectively analyzed in 42 primary AGN patients who received operative resection at a tertiary referral hospital in China between May 2005 and July 2016. RESULTS: The mean age of the patients at diagnosis was 35...
January 30, 2018: World Journal of Surgery
Ping Jin, Muhammad Usman Janjua, Qin Zhang, Chang-Sheng Dong, Youbo Yang, Zhao-Hui Mo
BACKGROUND: Primary bilateral macronodular adrenal hyperplasia is a rare cause of Cushing's syndrome characterized by the presence of bilateral secretory adrenal nodules. Recent studies have shown that primary bilateral macronodular adrenal hyperplasia is caused by combined germline and somatic mutations of the ARMC5 gene. Exophthalmos is an underappreciated sign of Cushing's syndrome. CASE PRESENTATION: A 52-year-old Chinese woman with progressively worsening bilateral proptosis presented to our hospital...
January 18, 2018: Journal of Medical Case Reports
Giovanni Conzo, Claudio Gambardella, Giancarlo Candela, Alessandro Sanguinetti, Andrea Polistena, Guglielmo Clarizia, Renato Patrone, Francesco Di Capua, Chiara Offi, Mario Musella, Sergio Iorio, Giseppe Bellastella, Daniela Pasquali, Annamaria De Bellis, Antonio Sinisi, Nicola Avenia
BACKGROUND: Laparoscopic adrenalectomy is considered the gold standard technique for the treatment of benign small and medium size adrenal masses (<6 cm), due to low morbidity rate, short hospitalization and patient rapid recovery. The aim of our study is to analyse the feasibility and efficiency of this surgical approach in a broad spectrum of adrenal gland pathologies. METHODS: Pre-operative, intra-operative and post-operative data from 126 patients undergone laparoscopic adrenalectomy between January 2003 and December 2015 were retrospectively collected and reviewed...
January 11, 2018: BMC Surgery
Eustratia Mpaili, Demetrios Moris, Diamantis I Tsilimigras, Dimitrios Oikonomou, Timothy M Pawlik, Dimitrios Schizas, Alexandros Papalampros, Evangelos Felekouras, Dimitrios Dimitroulis
BACKGROUND: The aim of this study was to review the current literature on the role of laparoscopic adrenalectomy (LA) in the treatment of primary adrenocortical carcinoma (ACC; European Network for the Study of Adrenal Tumors [ENSAT] I-III) in adults. MATERIALS AND METHODS: Nonrandomized controlled trials published between January 1999 and February 2017 were identified by searching the Pubmed, EMBASE, Cochrane Library, and Google Scholar databases. Primary and secondary endpoints included surgical and pathological parameters (patients age, tumor size, ENSAT stage, type of surgical approach, and period of follow-up), surgical outcomes (operative time, estimated blood loss, length of hospital stay, conversion rate to laparotomy, R0 resection, and surgical margin's status), and oncological outcomes (rate of recurrence, disease-free survival [DFS], and overall survival [OS] rates)...
January 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
V Tuka, M Matoulek, J Rosa, O Petrák, O Mikeš, Z Krátká, B Štrauch, R Holaj, T Zelinka, J Widimský
Primary aldosteronism (PA) is associated with objectively measured lower physical fitness and blunted response of the renin-angiotensin-aldosterone system to exercise. The purpose of this pilot study was to objectively measure exercise response of the renin-angiotensin-aldosterone system and cardiopulmonary fitness changes after laparoscopic adrenalectomy (ADE) in patients with unilateral PA. We examined a total of 14 patients with confirmed PA before and after ADE, by means of spiroergometry and hormonal evaluation...
January 5, 2018: Physiological Research
Masahiro Shibata, Takahiro Inaishi, Noriyuki Miyajima, Yayoi Adachi, Yuko Takano, Kenichi Nakanishi, Dai Takeuchi, Sumiyo Noda, Yuichi Aita, Kazuhiro Takekoshi, Yasuhiro Kodera, Toyone Kikumori
BACKGROUND: Recent advance of genetic testing has contributed to the diagnosis of hereditary pheochromocytoma and paraganglioma (PPGL). The clinical characteristics of hereditary PPGL are varying among the types of mutational genes. It is still difficult to specify the pathognomonic symptoms in the case of rare genetic mutations. Here, we report the case of synchronous bilateral pheochromocytomas and paraganglioma with novel MYC associated factor X (MAX) gene mutation. CASE PRESENTATION: A 24-year-old female had hyperhidrosis and hypertension...
December 28, 2017: Surgical Case Reports
Lütfi Soylu, Oğuz Uğur Aydın, Mustafa Cesur, Serdar Özbaş, Selçuk Hazinedaroğlu
Acute hypokalemic paralysis is a relatively rare cause of acute weakness. It may resolve spontaneously; however, it may be a potential life-threatening condition. Hypertension may be considered the most important finding in combination with hypokalemic paralysis for raising the suspicion of primary hyperaldosteronism (PHA). A 55-year-old hypertensive Mexican woman was admitted to the Emergency Unit with a sudden onset of generalized paralysis. An endocrinological workup and an abdominal magnetic resonance imaging revealed PHA with a 1...
2017: Turkish Journal of Surgery
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