Laparoscopic bilateral anterior transperitoneal adrenalectomy: 24 years experience

Balla, Andrea; Ortenzi, Monica; Palmieri, Livia; Corallino, Diletta; Meoli, Francesca; Ursi, Pietro; Puliani, Giulia; Sbardella, Emilia; Isidori, Andrea M.; Guerrieri, Mario; Quaresima, Silvia; Paganini, Alessandro M.

doi:10.1007/s00464-019-06665-6

Cited by 11 publications

(8 citation statements)

References 29 publications

(59 reference statements)

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“…Laparoscopy-specific complications were not observed in any patient. Massive bleeding, pulmonary complications, sepsis and cardiopulmonary failure are the most common causes of mortality after LA 25 . In our series, perioperative mortality occurred in two patients.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, while ASA scores showed similar characteristics in both groups, the number of patients with 1-2 ASA scores were significantly higher than the ASA 3 in the LA group(p=0.529).The number of hormoneactive masses was higher in LA patients(p=0.013).Consistent with the literature, no difference was found between groups in terms of tumor localization(p=0.229) 19,24 . It has been reported that bilateral adrenalectomy can be performed safely with a laparoscopic approach 25 . We performed bilateral LA safely in 4 patients.…”

Section: Discussionmentioning

confidence: 99%

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Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Dalcı

Topal

Ünal

et al. 2019

Cukurova Medical Journal

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The aim of this study was to compare the results of conventional and laparoscopic adrenalectomy in adrenal mass cases operated on during a 9-year period. Materials and Methods: A total of 81 patients who underwent adrenalectomy were included in the study. Patients were divided into two groups as; Group 1conventional surgery and Group 2-laparoscopic surgery. Two groups were compared retrospectively on characteristics such as; age, sex, body mass index (BMI), American Society of Anesthesiologists' score (ASA), mass localization, mass size and hormonal activity of the mass, duration of operation, amount of bleeding in operation, duration of hospitalization, duration until food intake, perioperative mortality, early complications and readmission to hospital within 90 days. Results: There were 22 patients in Group 1 and 59 patients in Group 2. No statistically significant difference was found between the groups in terms of age, sex, BMI, ASA score, tumor localization, indications for operation, postoperative complication, perioperative mortality and re-admittance within 90 days. The hormonal activity of the mass was higher and the mass was smaller in size in Group 2. The duration of operation (min), the amount of bleeding in the operation (ml), the duration until oral intake (days) and the length of hospital stay (days) were found to be statistically significantly higher in Group 1. Conclusion: Laparoscopic adrenalectomy should be the preferred surgical method because of its short duration of operation, low blood loss, early onset of oral food intake and shorter hospital stay, as well as its safety. Amaç: Bu çalışmada, 9 yıl içerisinde adrenal kitle nedeni ile ameliyat edilen olgularda konvansiyonel ve laparoskopik adrenalektominin sonuçlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Adrenalektomi uygulanan 81 hasta çalışmaya dahil edildi. Grup 1 konvansiyonel, Grup 2 Laparaskopik cerrahi olarak hastalar iki grupa ayrıldı. İki grup, yaş, cinsiyet, vücut kitle indeksi (VKİ), Amerikan anestezistler derneği skoru (ASA), kitle lokalizasyonu, kitle büyüklüğü ve kitlenin hormonal aktivitesi, operasyon süresi, operasyonda kanama miktarı, yatış süresi, gıdaya başlama süresi, perioperatif mortalite, erken dönem komplikasyonlar ve 90 gün içinde hastaneye tekrar başvuru gibi özellikleri esas alınarak retrospektif olarak karşılaştırıldı. Bulgular: Grup 1'de 22, Grup 2'de 59 hasta mevcut idi. Gruplar arasında yaş, cinsiyet, VKİ, ASA skoru, tümör lokalizasyonu, operasyon endikasyonları, postoperatif komplikasyon, perioperatif mortalite ve 90 gün içinde tekrar başvuru açısından istatistiksel olarak anlamlı fark saptanmadı. Kitlenin hormonal aktivitesi Grup 2'de daha yüksek, boyutu ise daha küçük saptandı. Operasyon süresi (dak), ameliyatta kanama miktarı (ml), oral alım süresi (gün) ve hastanede yatış süresi (gün) Grup 1'de daha fazla ve istatiksel olarak anlamlı bulundu. Sonuç: Laparoskopik adrenalektomi uygun hastalarda, kısa operasyon süresi, az kan kaybı, oral gıdaya erken başlama süresi ve daha kısa hastanede kalış sü...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Dalcı

Topal

Ünal

et al. 2019

Cukurova Medical Journal

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“…Besides diagnosis, spot urine specimens may make follow-up of PPGLs easier, since this group of patients should be screened annually for at least 10 years following initial surgery for local or metastatic recurrences or new tumours (43). Annual follow-up for life is required for high-risk patients (young patients and those with a genetic disease, a large tumour and/or a paraganglioma) (44).…”

Section: Figurementioning

confidence: 99%

Random ‘spot’ urinary metanephrines compared with 24-h-urinary and plasma results in phaeochromocytomas and paragangliomas

Sbardella

Maunsell

May

et al. 2020

European Journal of Endocrinology

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Background In patients with phaeochromocytomas or paragangliomas (PPGLs), 24-h urine collections for metanephrines (uMNs) are cumbersome. Objective To evaluate the diagnostic utility of ratios to creatinine of ‘spot’ uMNs. Methods Concentrations of uMNs and plasma metanephrines (pMNs) were measured by HPLC-mass-spectrometry. We retrospectively compared correlations of 24-h-urine output and ratio to creatinine in historical specimens and prospectively assessed 24-h and contemporaneous spot urines and, where possible, pMNs. Using trimmed log-transformed values, we derived reference intervals based on age and sex for spot urines. We used multiples of upper limit of normal (ULNs) to compare areas under curves (AUCs) for receiver-operator characteristic curves of individual, and sum and product of, components. Results In 3143 24-h-urine specimens on 2416 patients, the correlation coefficients between the ratios and outputs of metanephrine, normetanephrine and 3-methoxytyramine in 24-h urines were 0.983, 0.905 and 0.875, respectively. In 96 patients, the correlations between plasma concentrations, urine output and ratios in spot specimens were similar to those for raw output or ratios in 24-h specimens. Of the 160 patients with PPGLs, the CIs for AUCs for individual metabolites overlapped for all four types of measurement, as did those for the sum of the multiple ULNs although these were slightly higher (AUC for spot urine: 0.838 (0.529–1), plasma: 0.929 (0.874–0.984) and output: 0.858 (0.764–0.952)). Conclusions Ratios of fractionated metanephrines to creatinine in spot urine samples appear to have a similar diagnostic power to other measurements. The ease of spot urine collection may facilitate diagnosis and follow-up of PPGLs through improved patient compliance.

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“…Currently, BA is almost always performed laparoscopically with low morbidity . It leads to permanent resolution of hypercortisolism in the vast majority of cases, the exception being the rare patients with ectopic adrenal rest tissue.…”

Section: Bilateral Adrenalectomymentioning

confidence: 99%

Current management of Cushing's disease

Tritos

Biller

2019

J Intern Med

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Laparoscopic bilateral anterior transperitoneal adrenalectomy: 24 years experience

Cited by 11 publications

References 29 publications

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Random ‘spot’ urinary metanephrines compared with 24-h-urinary and plasma results in phaeochromocytomas and paragangliomas

Current management of Cushing's disease

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