Background: A significant proportion of the human genome is comprised of human endogenous retroviruses (HERVs). HERV transcripts are found in every human tissue. Expression of proviruses of the HERV-K(HML-2) family has been associated with development of human tumors, in particular germ cell tumors (GCT). Very little is known about transcriptional activity of individual HML-2 loci in human tissues, though.
Study Type – Practice patterns (retrospective cohort)
Level of Evidence 2b
OBJECTIVE
• To evaluate the safety and feasibility of laparoscopic adrenalectomy (LA) performed in several German centres with different laparoscopic experience, as LA has become the gold‐standard approach for benign surgical adrenal disorders; however, for solitary metastasis or primary adrenal cancer its precise role is uncertain.
PATIENTS AND METHODS
• The data of 363 patients who underwent a LA were prospectively collected in 23 centres.
• All centres were stratified into three groups according to their experience: group A (<10 LAs/year), group B (10–20 LAs/year) and group C (>20 LAs/year).
• In all, 15 centres used a transperitoneal approach, four a retroperitoneal approach and four both approaches.
• Demographic data, perioperative and postoperative variables, including operating time, surgical approach, tumour size, estimated blood loss, complications, hospital stay and histological tumour staging, were collected and analysed.
RESULTS
• The transperitoneal approach was used in 281 cases (77.4%) and the retroperitoneal approach was used in 82 patients (22.6%).
• In all, 263 of 363 lesions (72.5%) were benign and 100 (27.5%) were malignant.
• The mean (sd) operating time was 127.22 (55.56) min and 130.16 (49.88) min after transperitoneal and retroperitoneal LA, respectively.
• The mean complication rates for transperitoneal and retroperitoneal LA were 5% and 10.9%, respectively.
CONCLUSION
• LAs performed by urologists experienced in laparoscopy is safe for the removal of benign and malignant adrenal masses. LA for malignant adrenal tumours should be performed only in high‐volume centres by a surgeon performing at least >10 LAs/year.
A tumor embolism with occlusion of the left pulmonary artery was the first manifestation of a hypernephroma. After angiographic diagnosis, embolectomy was performed successfully using the heart-lung-machine. Four days later, nephrectomy followed. In the meantime, the patient has experienced a period of 3 years free of symptoms and metastases.
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