AIM To analyze patient demographics, pathology, surgical procedure and outcome in initial 24 consecutive patients who underwent laparoscopic adrenalectomy in our department. METHODS Twenty four patients underwent laparoscopic adrenalectomy between September 2000 and August 2005. There were 12 males and 12 females with a mean age of 44.6 years (range 25-68 years). The indications for adrenalectomy were pheochromocytoma (13 patients), Cushings syndrome (5 patients), myelolipoma (2 patients), adrenal cyst (2 patients), aldosteronoma (1 patient) and adrenal incidentaloma (1 patient). Nineteen of our patients with functioning adrenal tumours were prepared preoperatively for periods ranging up to 2 weeks by the endocrinologist. All laparoscopic adrenalectomies were performed via lateral transperitoneal approach using standard four-port technique. Patients with pheochromocytoma and Cushings syndrome were monitored in the surgical intensive care unit during immediate postoperative period. The clinical and
Since 1992, transabdominal LA(laparoscopic adrenalectomy) has been a standard method of adrenalectomy. This traditional method has been used widely because this procedure provides wide view of the whole abdomen which is familiar to surgeons. But due to its unique location at retroperitoneum, adrenal is still not easy to approach. So various retroperitoneal approaches were designed and adjusted. Among those, PRA(posterior retroperitoneal adrenalectomy) has showed good outcomes in many institutes. PRA facilitates direct approach to kidney and adrenal gland, and so operative time can be shortened. But there has been no randomized controlled trial between these two methods.. Therefore, as experienced surgeons in both methods, we want to practice this study. ...
Introduction: Patients with subclinical Cushing s syndrome (SCS) present with increased cardiovascular morbidity and mortality, however, the beneficial effect of adrenalectomy on cardiovascular risk factors is uncertain.. Objective: Systematic meta-analysis to determine the effect of adrenalectomy vs conservative follow-up on cardiovascular risk factors in patients with adrenal tumors and SCS.. Methods: We searched 6 databases through July 2014. Pairs of independent reviewers selected studies and appraised the risk of bias. We included and extracted studies with at least five SCS patients with adrenal tumors undergoing adrenalectomy where outcomes of interest were measured before and after surgery. Outcomes of interest included hypertension, diabetes, dyslipidemia, and obesity. In majority of studies, improvement of an outcome was defined as postsurgical decrease in dose, number or discontinuation of medications used to treat the comorbidity.. Results: Definition of SCS was heterogeneous among ...
TY - JOUR. T1 - Effects of adrenalectomy on CCD. T2 - Evidence for diferential response of two cell types. AU - Muto, S.. AU - Giebisch, G.. AU - Sansom, S.. PY - 1987/12/1. Y1 - 1987/12/1. N2 - Electrophysiological and chemical methods were used to determine the Na and K transport properties of the isolated cortical collecting duct (CCD) of control and adrenalectomized (ADX) rabbits. Net fluxes of Na (J(Na)) and K (-J(K)) in controls were 5.7 and 3.2 pmol·mm-1·min-1 and in ADX were 1.0 and 0.7 pmol·mm-1·min-1, respectively, similar to electrically determined rates. In separate experiments, blind impalement of cells from adrenal intact (group 1), ADX (group 2), and ADX rabbits treated with deoxycorticosterone (group 3) allowed identification of two distinct cell types, majority cells (MA) and minority cells (MI). In all groups, MA were distinguished from MI by a relatively high basolateral membrane potential (-V(b)), low apical membrane fractional resistance (FR(a)), and presence of apical ...
en] We investigated hemodynamics and plasma catecholamine concentrations in eight consecutive patients undergoing laparoscopic adrenalectomy for suspected pheochromocytoma. The same anesthesia protocol was used in all patients: a continuous infusion of sufentanil 0.5 microg x kg(-1) x h(-1) and isoflurane 0.4% (end-tidal) in 50% N2O/O2. Systolic arterial pressure was maintained between 120 and 160 mm Hg by adjusting an infusion of nicardipine, a calcium-channel blocker, while tachycardia (,100 bpm) was treated by 1-mg boluses of atenolol. Hemodynamics (thermodilution technique) and plasma catecholamine concentrations were measured before surgery, after the induction of anesthesia, after turning the patient to the lateral position, during pneumoperitoneum, during tumor manipulation, after adrenalectomy, and at the end of surgery. Two events resulted in significant catecholamine release: creation of the pneumoperitoneum and adrenal gland manipulation. As a consequence, a twofold increase in ...
Scherzer, A L.; Azar, H A.; Naujoks, G; and Williams, J, "Effect of castration and adrenalectomy on the thymus and other lymphoid organs of mice. Abstr." (1963). Subject Strain Bibliography 1963. 923 ...
Semantic Scholar extracted view of [Endocrine factors and metabolism of thiamine. I. Effect of adrenalectomy on the uptake and phosphorylation of thiamine in the liver of (alloxan) diabetic and nondiabetic rats]]. by V. Cappelli et al.
Wilson, Ollie Bernice, "The effect of adrenalectomy on the percent of hemolysis of erythrocytes in rats" (1955). ETD Collection for AUC Robert W. Woodruff Library. 941 ...
Wiernik, P H., "Effect of starvation of intact and adrenalectomized mice bearing lymphosarcoma p1798 on tumor regression and ribonuclease activity." (1970). Subject Strain Bibliography 1970. 1576 ...
During the study period 79 patients met inclusion criteria with an average age of 54 years (range 21-83). Average ASA score was 3 and 66% of patients were female. A laparoscopic approach was employed in 95% with a conversion rate of 3.8%. Average operating room time was 127 minutes (range 50-307) and blood loss of 114ml (range 10-1600). Unilateral adrenalectomy was performed in all but 1 patient who underwent bilateral adrenalectomy for pheochromocytoma. The most common indication for surgery was primary hyperaldosteronism caused by an aldosterone producing adenoma (63%). Average postoperative length of stay was 2.4 days (range 1-15). Morbidity and mortality were 13% and 0 respectively. Tumor size was significantly higher in patients with nonfunctional tumors (4.4cm vs. 2.9cm, p,0.003 ...
This Laparoscopic Adrenalectomy consultation is part of a series of consultations with surgical specialists at the University of California, San Diego.
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1. The effects of replacing a 1% NaCl drinking solution with Na+-free water for 2 days on body weight and fluid and electrolyte balances were studied in adrenalectomized and sham-operated rats.. 2. Eight weeks after operation, after the animals had been drinking Na+-free water for 2 days, some adrenalectomized animals (about 75%; designated group 1) experienced body weight losses which were outside the 99% confidence limits for the sham-operated rats (- 9.2 to + 5.3 g) whereas the remainder (designated group 2) were indistinguishable from the controls.. 3. The body weight loss in group 1 was associated with negative fluid, Na+ and K+ balances. In group 2 rats, fluid balance was maintained as well as in the sham-operated rats, but their handling of Na+ and K+ was different.. 4. In a separate experiment, plasma aldosterone, corticosterone, catecholamine and solute concentrations were measured in adrenalectomized rats from groups 1 and 2 (selected on the basis of body weight loss whilst drinking ...
Patients with a mild form of Cushing syndrome, a metabolic disorder caused by adrenal tumors, demonstrate substantial clinical improvement after adrenalectomy.
The brain 5-HT (serotonin) system and circulating corticosteroids are in close interaction and both are implicated in the pathogenesis of affective disorders. The 5-HT1A receptor is thought to play a major role in this relationship. However, the recently cloned 5-HT7 receptor may also be involved, given its pharmacological similarities to the 5-HT1A receptor and its high expression in corticolimbic structures. Using in situ hybridization histochemistry, we have investigated 5-HT7 and 5-HT1A receptor mRNA expression in selected areas of the rat brain 7 days post-adrenalectomy. 5-HT7 receptor mRNA was increased in CA1 and CA3b after adrenalectomy, with no alterations in other hippocampal subfields or in retrosplenial cortex. Adrenalectomy was associated with a marked increase of 5-HT1A receptor mRNA in dentate gyrus, CA3 and CA2, but not in CA1, nor in the raphe. These data indicate that circulating adrenal steroids have a inhibitory role on the expression of hippocampal 5-HT7 receptors as well as 5-HT1A
N Engl J Med. 1981 Sep 3;305(10):545-51. Clinical Trial; Comparative Study; Randomized Controlled Trial; Research Support, U.S. Govt, P.H.S.
PM Stewart, J Corrie, JR Seckl, CRW Edwards, PL Padfield; A Rational Approach in Assessing the Need for Corticosteroid Replacement Therapy. Clin Sci (Lond) 1 January 1988; 74 (s18): 67P-68P. doi: https://doi.org/10.1042/cs074067Pc. Download citation file:. ...
Sixteen patients (eight males and eight females) underwent an adrenalectomy. The demographic composition of patients is summarized in Table 1. The patients mean age was 58.00± 11.34 years (range, 33-76 years). Three patients had undergone previous abdominal surgery; a 54-year-old female who underwent surgery due to an ectopic pregnancy 25 years ago, a 68-year-old female who underwent an appendectomy 50 years ago, and a 69-year-old female who underwent a hysterectomy with uterine leiomyoma 25 years ago. Regarding other comorbidities, 11 patients had hypertension, two of which had diabetes mellitus. Among patients with both hypertension and diabetes mellitus, one patient had a history of microvascular angina. Among the other patients with hypertension, one patient had angina pectoris, one had unstable angina, one had hypertrophic cardiomyopathy, and one had both chronic renal failure and cerebral infarction. Regarding the location of the tumors, the tumor was positioned on the right adrenal ...
One adrenal gland sits above each of your kidneys. Your two adrenal glands produce various hormones that help regulate your metabolism, immune system, blood pressure, blood sugar and other essential functions. If a noncancerous (benign) adrenal tumor or adrenal cancer is discovered, you may require an adrenalectomy (uh-dree-nul-EK-tuh-me) to remove the adrenal gland that has the tumor. If one adrenal gland is removed, the other takes over full function without the need for supplemental medications.
Kirman I, Cekic V, Poltaratskaia N, et al. Plasma from patients undergoing major open surgery stimulates in vitro tumor growth: lower insulin-like growth factor binding protein 3 levels may, in part, account for this change. Surgery 2002;132:186-92.PubMedCrossRefGoogle Scholar ...
Learn more about Adrenalectomy -- Open Surgery at Grand Strand Medical Center DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall Your Doctorrevision ...
RIOS GONZALEZ, Emilio y MARTINEZ-PINEIRO LORENZO, Luís. Current role of lymphadenectomy and adrenalectomy in radical surgery for renal cancer. Actas Urol Esp [online]. 2009, vol.33, n.5, pp.562-568. ISSN 0210-4806.. Radical nephrectomy is the only curative treatment for renal cell cancer. Standard treatment includes ipsilateral adrenalectomy and lymph node dissection. In recent years, development of nephron-sparing surgery and early detection of small renal tumors has led to question this approach. The role of lymphadenectomy and adrenalectomy in surgical treatment of renal cancer is reviewed.. Palabras clave : Renal cell cancer; Lymphadenectomy; Adrenalectomy. ...
Responses to angiotensin II were also depressed in adrenalectomized rats (Figure 2). Bolus angiotensin injections in isolated lungs produced typical transient
The administration of 3-methylcholanthrene to rats is accompanied by an increase in the incorporation of orotic acid-14C into the 45 S cytoplasmic particle in the liver. The elevation reaches a maximum at 15 hr after the injection of the polycyclic hydrocarbon and diminishes to control values by 36 hr. This effect was also observed in adrenalectomized animals, eliminating any role of the adrenal corticosteroids in the phenomenon. In addition, the turnover of 18 and 28 S ribosomal RNA in liver cytoplasm was elevated after administration of the polycyclic hydrocarbon. These results suggest that the synthesis of ribosomal constituents, in particular, ribosomal RNA, may play an important role in the "induction" phenomenon observed in liver after administration of 3-methylcholanthrene.. ...
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1. A human urinary thermostable glycoprotein (ABG-TsU) believed to be a homologue of the plasma aldosterone-binding globulin (ABG) was isolated and purified by differential ultra-filtration, ion-exchange chromatography and gel filtration to electrophoretic homogeneity; it showed a charge heterogeneity in electrofocussing.. 2. ABG-TsU was administered intraperitoneally to male rats in small daily doses (7 μg/day per rat). Sustained hypertension developed in 5-8 days.. 3. The treated rats showed no changes in plasma electrolytes, aldosterone or plasma renin activity; however, a significant increase in heart weight was observed.. 4. This hypertension appears to be adrenal dependent since it is prevented by bilateral adrenalectomy or administration of an aldosterone antagonist, but not by adrenalectomy when aldosterone is given concomitantly with ABG-TsU.. ...
Incidental findings of adrenal tumours,incidentalomas, occur in 1-5 % in the general population and 10-25 % of these patients will exhibit biochemical mild hypercortisolism. Although the patients do not have clinical signs of classical Cushings syndrome, they have an increased risk for hypertension, dyslipidemia, diabetes mellitus, osteoporosis and obesity.. The hypothesis of the study is, that surgery of the adrenal adenoma responsible for the increased secretion of cortisol, will in part cure or ameliorate the metabolic syndrome. ...
A 27 year old female G2 p1001 @ 7 week gestation was referred to our institution without obstetric services for persistent hypertension, palpitations, headache, lightheadedness, and fatigue and a family history of pheochromocytoma. Initial 24 hour urine revealed elevated dopamine, epinephrine and plasma norepinephrine levels. An abdominal MRI showed a 1.9 x 2.2 cm mass in the right adrenal gland along with several enlarged epigastric lymph nodes. The patient was started on phenoxybenzamine and labetalol. A laparoscopic adrenalectomy was planned at 15 week gestation pending stable hemodynamics. Surgery planned to have gastroenterology do an upper endoscopy with biopsy of the epigastric lymph nodes a week prior to her surgery, however, at the insistence of the obstetric anesthesiologist, the endoscopic procedure was scheduled at the time of the laparoscopy. Endocrinology was followed her vital signs on an outpatient basis prior to surgery, which required an increase in alpha and beta blockade due ...
possible extrathymic T cells (i.e. CD56þ T cells and CD57þ T Therefore, we used adrenalectomized mice in an attempt to cells) [9,10]. It was found that cell populations could be classified identify possible influences on the circadian rhythm [17]. These into two groups: one group with daytime rhythm includes granu- mice lost such circadian rhythms, implying some hormonal reg- locytes, monocytes, NK cells, extrathymic T cells, gd T cells, and ulation. However, because of impaired mobility, they also lost the CD8þ cells. The other, with night rhythm, includes conventional T variation of their physical activity round the clock. Changes in the and B cells, ab T cells, and CD4þ cells. It is well known that NK activity of the autonomic nervous system might affect leucocyte cells, extrathymic T cells and gd T cells are involved in natural subsets, some of them carrying adrenergic or cholinergic receptors immunity and are more primitive than conventional T (and ab T) [11,12]. There are many reports ...
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It has repeatedly been shown that angiotensin II pretreatment enhances the subsequent hypoxic pressor responses in preparations perfused with artificial
1. When the suprarenal glands are removed from drakes they die after a mean interval of about 8 hours. They can be kept alive by the hourly injection of cortical extract. The amount of extract which must be injected varies at different times in the year, becoming much larger during the breeding season.. 2. The testes of the drake out of the breeding season weigh 1 to 4 grams. From January to May they increase in size to about 80 grams. During June they rapidly decline to the former small size. The curve of change in weight is closely parallel to the curve for the amount of cortical extract required after adrenalectomy, but the changes in the latter curve precede those in the former.. 3. After adrenalectomy castrated drakes require one third to one half of the amount of cortical extract necessary to keep normal birds alive during the breeding season. The increase in requirement of cortical extract during the breeding season is not due to the large amount of male hormone in the circulation, since ...
We found no significant adaptation of the HPA axis to chronic FS, but did of glucose and other variables. A single exposure to FS did not cause long-term effects on the responsiveness of the HPA axis to the same stressor in contrast to that observed after IMO. We then studied the effects of single versus repeated exposure to IMO on the HPA response to the same stressor in both sham-operated and adrenalectomized rats maintained with corticosterone in their drinking saline (ADX+B). In sham rats, daily exposure to IMO had similar effects on the HPA axis that a previous single session. In contrast, in ADX+B rats, a reduction of the ACTH response to the stressor was observed in repeated but not single IMO rats. The present result suggest that the glucocorticoids are not mandatory for the development or adaptation of the HPA axis to chronic IMO, but they may be involved in the induction or expression of long-term effects of IMO on the HPA responsiveness to the same stressor. In order to better study ...
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Exacerbation of autoimmune thyroid dysfunction after unilateral adrenalectomy in patients with Cushings syndrome due to an adrenocortical adenoma
TY - JOUR. T1 - Laparoscopic Versus Open Adrenalectomy for Adrenocortical Carcinoma. T2 - Surgical and Oncologic Outcome in 152 Patients: Editorial Comment. AU - Cadeddu, Jeffrey A. PY - 2011. Y1 - 2011. UR - http://www.scopus.com/inward/record.url?scp=84937218160&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84937218160&partnerID=8YFLogxK. U2 - 10.1016/j.juro.2010.12.025. DO - 10.1016/j.juro.2010.12.025. M3 - Article. AN - SCOPUS:84937218160. VL - 185. SP - 1222. JO - Journal of Urology. JF - Journal of Urology. SN - 0022-5347. IS - 4. ER - ...
Kieran, K., Anderson, J. R., Dome, J. S., Ehrlich, P. F., Ritchey, M. L., Shamberger, R. C., . . . Davidoff, A. M. (2013). Is adrenalectomy necessary during unilateral nephrectomy for wilms tumor? A report from the childrens oncology group. Journal of Pediatric Surgery, 48(7), 1598-1603.. ...
Ectopic adrenocorticotropic hormone (ACTH) production is an uncommon cause of Cushings syndrome and, rarely, the source can be a phaeochromocytoma. A 55-year-old man presented following an episode of presumed gastroenteritis with vomiting and general malaise. Further episodes of diarrhoea, joint pains and palpitations followed. On examination, he was hypertensive with no clinical features to suggest hypercortisolaemia. He was subsequently found to have raised plasma normetanephrines of 3.98 nmol/L (NR ,0.71) and metanephrines of 0.69 nmol/L (NR ,0.36). An adrenal CT showed a 3.8 cm right adrenal nodule, which was not MIBG-avid but was clinically and biochemically consistent with a phaeochromocytoma. He was started on alpha blockade and referred for right adrenalectomy. Four weeks later, on the day of admission for adrenalectomy, profound hypokalaemia was noted (serum potassium 2.0 mmol/L) with non-specific ST-segment ECG changes. He was also diagnosed with new-onset diabetes mellitus (capillary ...
Cardiac function was evaluated by ventricular function curves during the cardiovascular collapse observed in acute and chronic adrenal insufficiency. A progressive decline in peak cardiac work was observed in the acutely adrenalectomized cat (30% decrease at 1.8 hours and 50% at 3.5 hours after adrenalectomy). This impairment in cardiac work paralleled the decrease in mean arterial blood pressure which reached 50 mm Hg 3.5 hours after adrenalectomy. Cortisol and d-aldosterone, and the volume-expander, dextran, prevented a significant fall in mean arterial blood pressure and in peak cardiac work. When the mean arterial blood pressure of nonadrenalectomized cats was adjusted to follow the changes seen in adrenalectomized cats, a 49% depression in cardiac work resulted 3.5 hours after the initial decline in arterial blood pressure. The data suggest that the time course of the hypotension and presumed reduction in coronary perfusion pressure is sufficient to account for the large impairment in peak ...
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Genetic association studies hinge on definite clinical case definitions of the disease of interest. This is why more penetrant mutations were overrepresented in early multiple endocrine neoplasia 2 (MEN2) studies, whereas less penetrant mutations went underrepresented. Enrichment of genetic association studies with advanced disease may produce a flawed understanding of disease evolution, precipitating far-reaching surgical strategies like bilateral total adrenalectomy and 4-gland parathyroidectomy in MEN2. The insight into the natural course of the disease gleaned over the past 25 years caused a paradigm shift in MEN2: from the removal of target organs at the expense of greater operative morbidity to close biochemical surveillance and targeted resection of adrenal tumors and hyperplastic parathyroid glands ...
CLINICAL HISTORY AND RADIOLOGY. The patient was a 52 year old male with a history of Cushings disease, initially diagnosed at the age of 18. At that time, his symptoms included increased weight, purple abdominal striae, diabetes mellitus, and polydipsia. He underwent a resection of a pituitary microadenoma at another hospital. However, due to persistently high cortisol levels following the surgery, he later underwent a bilateral adrenalectomy. Following the operation, he began hydrocortisone therapy, lost weight, and was able to maintain glucose control without diabetes medications. At the age of 32 his diabetes recurred, but he was able to maintain good glucose control up until age 51 at which time his HbA1C was greater than 7. He also had visual problems with significant reduction in right peripheral vision and moderate impairment in left. Testing revealed a greatly elevated serum ACTH at 5,082 pg/mL (normal is 9 - 46 pg/mL), but serum cortisol within normal limits 4 ug/dL. MRI scans found a ...
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Tumors of the adrenal cortex are reported in 2% of all autopsies, with the most common lesion being a benign adenoma (see the first image below). The common major pathologic entities of the adrenal gland that require surgical intervention are primary hyperaldosteronism (ie, Conn syndrome, see the second image below), Cushing syndrome, pheochr...
Learn about benign adrenal tumors and adrenal cancer treatment, such as an adrenalectomy, by endocrine surgeons at Brigham and Womens Hospital.
The Aldosteronoma Resolution Score (ARS) is currently the most accurate prediction model for complete resolution of hypertension after adrenalectomy, taking into account 4 preoperative clinical parame... more
Researchers from Germany looked at the clinical parameters that predict hypertension resolution following laparascopic adrenalectomy.
High levels of estrogen causes an increase in levels of cortisol-binding globulin which - you guessed it - binds cortisol in the blood. The amount of free cortisol available to enter the cell membranes and activate receptors inside the cell is now
The effect of alterations in extracellular fluid volume (ECV) and solute concentration on excretion of urinary kallikrein was examined in conscious Sprague-Dawley rats. Animals were given infusions of either dextrose and water, saline, or albumin according to a variety of protocols. These were designed to evaluate possible relationships between excretion of kallikrein, volume, sodium, and potassium. A reproducible pattern of kallikrein excretion was noted in all volume expanded groups. This consisted of a short lived increase during the initial hour of expansion with a subsequent fall to lower levels than baseline and a gradual recovery. To define the role of aldosterone in these studies, an adrenalectomized group and a group of appropriately prepared sham controls were expanded with saline. Adrenalectomy did not effect this pattern. We postulate a tubular "washout" phenomenon as the etiology of these observations. Results of these studies fail to demonstrate a consistent relationship between ...
The adrenal glands are part of the endocrine system, which regulates hormone levels in the body. They are small, pyramid-shaped glands that rest on th...