Functional Adrenal Cortex Preservation: A Good Reason for Posterior Retroperitoneal Endoscopic Approach

ConclusionsCortical-sparing adrenalectomy by the retroperitoneal endoscopic approach, in expert hands, is safe and feasible for the treatment of hereditary and sporadic pheochromocytoma in a context of low malignancy, making it possible to avoid the need for corticoid replacement in most cases.ResumenIntroducciónLa adrenalectomía con preservación cortical se indica como tratamiento del feocromocitoma bilateral hereditario y esporádico, en casos de bajo riesgo de malignidad, para reducir la posibilidad de insuficiencia suprarrenal asumiendo la eventualidad de una recidiva local. El objetivo del estudio es analizar los resultados funcionales de la adrenalectomía parcial por vía endoscópica retroperitoneal en pacientes monoadrenales o que necesiten una adrenalectomía bilateral.MétodosEntre enero de 2015 y febrero de 2016 se incluyeron de forma prospectiva pacientes con feocromocitoma asociado a mutaciones con bajo riesgo para malignidad, que aceptaron participar en el estudio. Todos fueron operados por cirujanos especialmente entrenados en este tipo de cirugía, utilizando la misma técnica quirúrgica. Se recogieron variables demográficas y características clínicas, realizando posteriormente el análisis descriptivo de dichas variables.ResultadosSe registraron un total de 6 pacientes, cuatro asociados al síndrome MEN tipo 2 y dos en contexto del síndrome VHL...
Source: Cirugia Espanola - Category: Surgery Source Type: research

Related Links:

Authors: Apostu D, Lucaciu O, Mester A, Oltean-Dan D, Baciut M, Baciut G, Bran S, Onisor F, Piciu A, Pasca RD, Maxim A, Benea H Abstract Articular cartilage has a complex structure and metabolism which allow for a proper movement within joints. Nevertheless, several systemically administered pharmacological agents have been proved to improve the anabolic response in the case of cartilage lesions. Alendronate, glucosamine, chondroitin sulfate, hyaluronic acid, collagen hydrolysate, vitamin C, vitamin D, aspirin and strontium ranelate have shown positive results in clinical trials. On the other hand, calcitonin, rise...
Source: Drug Metabolism Reviews - Category: Drugs & Pharmacology Tags: Drug Metab Rev Source Type: research
ConclusionsLSC is feasible, with equivalent intraoperative complication rates for normal weight, overweight and obese women when performed by experienced laparoscopic urogynaecologists. Given the benefits of a laparoscopic approach in obese women, the authors suggest they should be offered LSC as an option to treat vault prolapse when surgical management is being considered.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
CONCLUSION: Optic neuritis is a pathology frequently encountered in ophthalmology; a good knowledge of symptoms and clinical signs is essential for early diagnosis and optimal management. The identification of autoantibodies, including anti-MOG antibodies, is important for patient management and is part of the required testing for all cases of optic neuritis, in order to adapt the treatment of the acute episode and to provide maintenance therapy to avoid recurrence. PMID: 31732265 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
CONCLUSIONS: Cortical-sparing adrenalectomy by the retroperitoneal endoscopic approach, in expert hands, is safe and feasible for the treatment of hereditary and sporadic pheochromocytoma in a context of low malignancy, making it possible to avoid the need for corticoid replacement in most cases. PMID: 29804624 [PubMed - as supplied by publisher]
Source: Cirugia eEspanola - Category: Surgery Authors: Tags: Cir Esp Source Type: research
Abstract The investigation and management of unilateral adrenal incidentalomas have been extensively considered in the last decades. While bilateral adrenal incidentalomas represent about 15 percent of adrenal incidentalomas, they have been less frequently discussed. The differential diagnosis of bilateral incidentalomas includes metastasis, primary bilateral macronodular adrenal hyperplasia (BMAH) and bilateral cortical adenomas. Les frequent etiologies are bilateral pheochromocytomas, congenital adrenal hyperplasia, Cushing's disease or ectopic ACTH secretion with secondary bilateral adrenal hyperplasia, primary...
Source: European Journal of Endocrinology - Category: Endocrinology Authors: Tags: Eur J Endocrinol Source Type: research
Over the last years, the knowledge of MEN2 and non-MEN2 familial forms of pheochromocytoma (PHEO) has increased. In MEN2, PHEO is the second most frequent disease: the penetrance and age at diagnosis depend on the mutation of RET. Given the prevalence of bilateral PHEO (50% by age 50), adrenal sparing surgery, aimed at sparing a part of the adrenal cortex to avoid adrenal insufficiency, should be systematically considered in patients with bilateral PHEO. Non-MEN2 familial forms of PHEO now include more than 20 genes: however, only small phenotypic series have been reported, suggesting that phenotypic features of isolated h...
Source: Endocrine-Related Cancer - Category: Endocrinology Authors: Tags: Thematic Review Source Type: research
ConclusionAdrenal‐sparing surgery should be the standard approach for patients who have already been diagnosed with MEN2 or VHL when operating on the first side, whereas complete removal of the affected adrenal gland(s) is generally recommended for patients with SDHB or MAX germline mutations. Routine assessment of a patient's genotype, even after the first operation, can be crucial for adopting an appropriate strategy for follow‐up and future surgery.
Source: British Journal of Surgery - Category: Surgery Authors: Tags: Review Source Type: research
La chirurgie d’épargne surrénalienne : du cortex à la médulla: Cortical sparing surgery: from cortex to medulla. Ann Endocrinol (Paris). 2017 Oct;78 Suppl 1:S11-S20 Authors: Ferriere A, Kerlan V, Tabarin A Abstract The 2017 Endocrine Society annual meeting included several communications and debates on the conservative adrenal surgery in bilateral hereditary pheochromocytomas (BHP), bilateral adrenal macronodular hyperplasia (BAMH) and primary hyperaldosteronism (PHA). The general principle is to preserve a part of the adrenal cortex to prevent the occurrence of a def...
Source: Annales d'Endocrinologie - Category: Endocrinology Authors: Tags: Ann Endocrinol (Paris) Source Type: research
Hypothalamo‑hypophysial system in rats with autotransplantation of the adrenal cortex. Mol Med Rep. 2017 Mar 24;: Authors: Takizawa N, Tanaka S, Oe S, Koike T, Matsuda T, Yamada H Abstract Patients with bilateral pheochromocytoma often require an adrenalectomy. Autotransplantation of the adrenal cortex is an alternative therapy that could potentially be performed instead of receiving glucocorticoid replacement following adrenalectomy. Adrenal cortex autotransplantation aims to avoid the side effects of long‑term steroid treatment and adrenal insufficiency. Although the function of the hypothalamo...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
Authors: Rodrigues KC, Toledo RA, Coutinho FL, Nunes AB, Maciel RM, Hoff AO, Tavares MC, Toledo SP, Lourenço DM Abstract BACKGROUND: Scarce data on psychological harm in multiple endocrine neoplasia type 2 (MEN2) are available. OBJECTIVES: To assess anxiety, depression, quality of life and coping in long-standing MEN2 patients. PATIENTS AND METHODS: Forty-three adults (age ≥ 18 y) with clinical and genetic diagnosis of MEN2 and long-term follow-up (10.6±8.2 years; 1-33). A cross-sectional study with qualitative and quantitative psychological assessment using semi-directed interviews and HAD...
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
More News: Addison's Disease | Adrenal Insufficiency | Cancer & Oncology | Corticosteroid Therapy | Hormones | Laparoscopy | Pheochromocytoma | Study | Surgery