Évolution de la prise en charge de la pathologie surrénalienne depuis l'avènement de la laparoscopie. Une étude rétrospective de 220 patients

Lifante, Jean Christophe; Cenedese, A; Vila, Juan Manuel Fernández; Peix, J. L.

doi:10.1016/j.anchir.2005.03.011

Cited by 12 publications

(6 citation statements)

References 16 publications

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“…One of the greatest concerns here is the borderline tumor size that constitutes an indication for surgery [17, 18]. The upper limit of the size of tumors that can be removed by minimally invasive technique has not been clearly established.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Incidentalomas: Should We Operate on Small Tumors in the Era of Laparoscopy?

Pędziwiatr

Natkaniec

Kisialeuski

et al. 2014

International Journal of Endocrinology

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Tumor size smaller than 4 cm as an indication for surgical treatment of incidentaloma is still a subject of discussion. Our aim was the estimation of the incidence of malignancy and analysis of treatment outcomes in patients with incidentaloma smaller than 4 cm in comparison to bigger lesions. 132 patients who underwent laparoscopic adrenalectomy for nonsecreting tumors were divided into two groups: group 1 (55 pts., size < = 40 mm) and group 2 (77 pts., size > 40 mm). Operation parameters and histopathological results were analyzed. No differences in group characteristics, mean operation time, and estimated blood loss were noted. Complications in groups 1 and 2 occurred in 3.6% and 5.2% of patients, respectively (P = 0.67). Malignancy in groups 1 and 2 was present in 1 and 6 patients, respectively (P = 0.13). Potentially malignant lesions were identified in 4 patients in group 1 and 4 patients in group 2 (P = 0.39). The results do not allow for straightforward recommendations for surgical treatment of smaller adrenal tumors. The safety of laparoscopy and minimal, but impossible to omit, risk of malignancy support decisions for surgery. On the other hand, the risk of malignancy in smaller adrenal tumors is lower than surgical complications, which provides an important argument against surgery.

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Section: Discussionmentioning

confidence: 99%

Adrenal Incidentalomas: Should We Operate on Small Tumors in the Era of Laparoscopy?

Pędziwiatr

Natkaniec

Kisialeuski

et al. 2014

International Journal of Endocrinology

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“…Comparative human studies have shown the benefits of minimally invasive techniques for removal of benign adrenal tumors (either functional or nonfunctional) of <12 cm in size 13–16 . Potential benefits of minimally invasive approaches include decreased requirements for analgesics, fewer adrenalectomy‐related complications, improved patient satisfaction, shorter hospital stays, and faster recovery periods when compared with open surgery 14–34 . Interestingly, laparoscopic ovariohysterectomy in dogs is associated with reduced postoperative pain and surgical stress compared with an open technique 35–37 .…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic adrenalectomy in humans was reported in 1992 11,12 and is most often used for benign functional and nonfunctional tumors (<12 cm in size) of the adrenal glands 13–16 . Laparoscopic adrenal surgery may offer several advantages including fewer wound complications, reduced morbidity, improved comfort and cosmetic appeal, reduced bleeding, better observation of abdominal organs, shorter hospital stays, and faster recovery periods 14–34 . Advantages of minimally invasive surgical procedures in dogs compared with open surgical procedures have been reported and laparoscopic ovariohysterectomy reduces postoperative pain and surgical stress compared with the open technique 35–37 …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Adrenalectomy for Treatment of Unilateral Adrenocortical Carcinomas: Technique, Complications, and Results in Seven Dogs

2008

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Objective-To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. Study Design-Case series. Animals-Dogs (n ¼ 7) with Cushing's syndrome caused by unilateral adrenocortical carcinoma. Methods-Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5-12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. Results-Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). Conclusions-Laparoscopic adrenalectomy is feasible in dogs with either right-or left-sided adrenocortical carcinoma not involving the caudal vena cava. Clinical Relevance-When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs. r

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“…Cependant, ils sont les examens de choix dans les pays développés dans le diagnostic et la surveillance des phéochromocytomes [8,17]. La prédominance du phéochromocytome droit et la rareté de la forme bilatérale sont largement évoquées par la littérature [17,18,19] La durée moyenne de séjour de nos patientes était de 10,5 jours. Nos résultats semblent se superposer à ceux de la littérature.…”

Section: Discussionunclassified

“…Nos résultats semblent se superposer à ceux de la littérature. [18,19] Une mortalité nulle est généralement observée dans la littérature [7,20], cependant elle concernait 2 cas dans notre série. Comme dans la littérature [7], les comptes-rendus histologiques dans nos observations ont conclu à des phéochromocytomes bénins dans 90,9%.…”

Section: Discussionunclassified

Prise en Charge Du Pheochromocytome : Experience Du Service De Chirurgie Generale De L’hopital General Idrissa Pouye

Ka, et al…

2023

JAFRCHIR

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Introduction: Pheochromocytomas (PH) are neuroendocrine tumors developed at the expense of chromaffin cells of the adrenal medulla or sympathetic chain paraganglia. It is a serious condition without the treatment which is essentially surgical. Our goal was to assess the epidemiological, clinical, paraclinical and therapeutic aspects of this pathology through a retrospective study conducted at the General Surgery Department of the Idrissa POUYE General Hospital in Dakar. Patients and method: This was a monocentric retrospective study carried out from January 2005 to December 2022. Included in this study were all patient files presenting an adrenal tumor whose biology or imaging was in favor of a pheochromocytoma. Results: During our study period, 22 cases of pheochromocytomas were treated in the general surgery department of the Idrissa POUYE general hospital. The average age of the patients was 36 years old with extremes of 16 and 66 years old. Sex concerned 86.3% (N; 19) with a sex ratio of 0.2. The average duration of symptom evolution was 10.31 months with extremes of 1 and 36 months. Hypertension associated or not with headaches was found in 81.8% of cases (N: 18). The urinary level of VMA was dosed in 6 patients and returned high in 3 cases (13.66%) The dosage of urinary metanephrines concerned 9 patients and it returned high in 88.8% of cases (N : 8). The plasma metanephrine level was very high in the 6 cases (27.3%) where it was measured. The blood sugar level was high in 2 cases. Abdominal ultrasound in 12 (54.5%) of our patients was in favor of a pheochromocytoma, while CT confirmed the diagnosis in 95.5% of our patients (N: 21). The location of the pheochromocytoma was right in 72.7%. (N: 16). All patients underwent adrenalectomy under general anesthesia. The duration of the hospital stay was 10.6 days on average, the mortality concerned two cases. One year postoperative follow-up was unremarkable. Histology was in favor of benign pheochromocytoma in 90.9%. Conclusion: At the end of our study, we can conclude that pheochromocytomas are rare tumors in young female subjects, generally benign. Surgical treatment accompanied by good resuscitation gives satisfactory results.

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Évolution de la prise en charge de la pathologie surrénalienne depuis l'avènement de la laparoscopie. Une étude rétrospective de 220 patients

Cited by 12 publications

References 16 publications

Adrenal Incidentalomas: Should We Operate on Small Tumors in the Era of Laparoscopy?

Adrenal Incidentalomas: Should We Operate on Small Tumors in the Era of Laparoscopy?

Laparoscopic Adrenalectomy for Treatment of Unilateral Adrenocortical Carcinomas: Technique, Complications, and Results in Seven Dogs

Prise en Charge Du Pheochromocytome : Experience Du Service De Chirurgie Generale De L’hopital General Idrissa Pouye

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