Successful Left Adrenalectomy for Metastatic Hepatocellular Carcinoma Using Hand-Assisted Laparoscopic Surgery: Report of a Case

Kitaoka, Fumio; Yanaga, Katsuhiko; Okudaira, Sadayuki; Tajima, Yoshimasa; Furui, Junichiro; Kanematsu, Takashi

doi:10.1007/s00595-004-2891-5

Cited by 10 publications

(5 citation statements)

References 11 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The technique has rarely been reported in the literature, although it is used at several centers in the treatment of large adrenal tumors. [13][14][15] Surgeons who have used the hand-assisted technique agree on its simplicity, and rather short learning curve, possibly because it brings together the best tools from two different techniques: manual handling allows the digital sensation of the open technique and is combined with the magnification of the videocameras. The handport facilitates traction of organs and dissection.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Adrenalectomy for Ectopic Cushing’s Syndrome—Discussions on Technique and Indication

et al. 2006

View full text Add to dashboard Cite

We conclude that bilateral handport-assisted laparoscopic adrenalectomy is safe, and that all surgical techniques in these severely ill patients may be troublesome and technically demanding. Early surgical intervention may reduce the technical disadvantages. Moreover, bilateral adrenalectomy can substantially reduce the symptoms of Cushing's syndrome, although effects on mortality are not obvious.

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral Adrenalectomy for Ectopic Cushing’s Syndrome—Discussions on Technique and Indication

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Some surgeons claim that tumors smaller than 5 cm in diameter are most suitable for laparoscopic surgery because extension of the skin incision and division of the tumor are not necessary, allowing complete use of laparoscopy. 16,21,22 Although our patient's tumor was larger than 5 cm, we removed it easily without extending the skin incision or dividing the tumor, because of the Lap disc fitted during the HALS. There are several approaches to retroperitoneal tumors, 13,23,24 but we chose the transperitoneal approach based on the tumor size, operative field, anatomic orientation, and hemostasis of particular vessels.…”

Section: Discussionmentioning

confidence: 97%

Noradrenalin-Secreting Retroperitoneal Schwannoma Resected by Hand-Assisted Laparoscopic Surgery: Report of a Case

et al. 2006

View full text Add to dashboard Cite

A 66-year-old woman was admitted to our hospital for investigation of a retroperitoneal mass. She was asymptomatic but her serum noradrenalin and vanillylmandellic acid levels were increased remarkably. Computed tomographic angiography showed a mass in the left side of the superior mesenteric artery (SMA) divergence, 6 x 4 cm in size, supplied mainly by the left adrenal artery. We performed hand-assisted laparoscopic surgery (HALS) using a Cavitron ultrasonic surgical aspirator. Abdominal exploration revealed that the tumor was located in the left side of the SMA root, but was not adhered to the adjacent organs. Her vital signs remained stable during the operation. Microscopic examination revealed a palisade formation, confirming a histopathological diagnosis of degenerated schwannoma (Antoni type B). Immunohistologically, the tumor cells were stained with S-100 protein and neuron-specific enolase. Her noradrenalin level normalized immediately after the operation and she remains in good health 3 years 2 months later.

show abstract

“…Minimally invasive techniques were chosen for tumors with a median diameter of 2.5 cm, whereas larger tumors (> 6 cm) prompted open adrenalectomy. Similarly, other centers reported the successful application of minimally invasive surgery for HCC adrenal metastasis [15, 28]. Due to the extended interval of this retrospective study (25 years), changes in the surgical management and the primary choice of techniques might have influenced the observed distribution of surgical techniques: in the early study period, also for smaller tumors, open surgery was chosen for adrenalectomy.…”

Section: Discussionmentioning

confidence: 99%

Survival After Adrenalectomy for Metastatic Hepatocellular Carcinoma: A 25‐year Institutional Experience

et al. 2020

View full text Add to dashboard Cite

Background Extrahepatic manifestation of hepatocellular carcinoma (HCC) is rare and primarily affects lung, lymph nodes and bone. Metastases to the adrenal glands are relatively infrequent. This 25-year institutional experience aimed for an analysis of factors influencing survival in patients undergoing surgery for HCC adrenal metastasis. Methods A retrospective analysis of the institutional database of the Clinic for General-, Visceral- and Transplantation Surgery of the University Medical Center Mainz, Germany, was performed. Patients who underwent surgery for HCC adrenal metastases from January 1995 to June 2020 were included. Pre-, peri- and postoperative factors with potential influence on survival were assessed. Results In 16 patients (14 males, two females), one bilateral and 15 unilateral adrenalectomies were performed (13 metachronous, three synchronous). Thirteen operations were carried out via laparotomy, and three adrenalectomies were minimally invasive (two laparoscopic, one retroperitoneoscopic). Median overall survival (after HCC diagnosis) was 35 months, range: 5–198. Median post-resection survival (after adrenalectomy) was 15 months, range: 0–75. Overall survival was longer in patients with the primary HCC treatment being liver transplantation (median 66 months) or liver resection (median 51 months), compared to only palliative intended treatment of the primary with chemotherapy (median 35 months) or local ablation (median 23 months). Conclusions Surgery is a feasible treatment option for patients with adrenal metastases originating from HCC. In patients who underwent adrenalectomy for HCC adrenal metastasis, overall survival was superior, if primary HCC treatment was potentially curative (liver transplantation or resection).

show abstract

Successful Left Adrenalectomy for Metastatic Hepatocellular Carcinoma Using Hand-Assisted Laparoscopic Surgery: Report of a Case

Cited by 10 publications

References 11 publications

Bilateral Adrenalectomy for Ectopic Cushing’s Syndrome—Discussions on Technique and Indication

Bilateral Adrenalectomy for Ectopic Cushing’s Syndrome—Discussions on Technique and Indication

Noradrenalin-Secreting Retroperitoneal Schwannoma Resected by Hand-Assisted Laparoscopic Surgery: Report of a Case

Survival After Adrenalectomy for Metastatic Hepatocellular Carcinoma: A 25‐year Institutional Experience

Contact Info

Product

Resources

About