Consequences of Peritoneal Tears During Hand-assisted Retroperitoneoscopic Nephroureterectomy

Ou, Chien Hui; Yang, Wen-Horng

doi:10.1016/j.urology.2010.02.056

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…This was most likely the result of catecholamine release after pressure was applied to the adrenal gland and should be expected if surgical excision is attempted and further cautions against attempting removal with the horse under standing sedation. Although this has not directly been documented in horses, these observations may explain the severe haemodynamic complications reported in horses positioned in dorsal recumbency undergoing exploratory celiotomy for colic‐like signs that had an undiagnosed pheochromocytoma at the time of surgery 11,22,23,24 …”

Section: Discussionmentioning

confidence: 99%

“…Although this has not directly been documented in horses, these observations may explain the severe haemodynamic complications reported in horses positioned in dorsal recumbency undergoing exploratory celiotomy for colic-like signs that had an undiagnosed pheochromocytoma at the time of surgery. 11,22,23,24 Because catecholamine-induced changes in blood pressure and heart rate were anticipated in this case, anaesthetic management preemptively included constant rate infusions of lidocaine as an antiarrhythmic and dexmedetomidine as an anti-arrhythmic/antisympathetic agent. 25,26 Additionally, intravenous magnesium is commonly used as a catecholamine blocker and anti-arrhythmic in human pheochromocytoma surgery and was also included in the protocol, though its use for this purpose in horses has not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

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Successful surgical removal of a pheochromocytoma in a mare via trans‐costal approach

O’Brien

Pezzanite

Acutt

et al. 2023

Equine Veterinary Journal

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BackgroundPheochromocytomas have been previously reported in horses, but successful antemortem diagnosis and surgical removal without recurrence of clinical signs have not been described.ObjectiveTo report the clinical presentation, diagnostic evaluation, surgical technique, anaesthetic management and post‐operative care of a mare diagnosed with pheochromocytoma.Study designClinical case report.MethodsAn 18‐year‐old Quarter Horse mare presented for recurrent episodes of colic, profuse sweating, muscle fasciculations and agitation over a 2‐month period. Clinical, clinicopathologic and ultrasonographic (transcutaneous, transrectal) abnormalities were consistent with a unilateral left‐sided adrenal mass. Surgical removal of the mass was performed via a trans‐costal approach with removal of the 18th rib and retraction of the left kidney to improve exposure. Associated vasculature was ligated, and the adrenal mass was removed and submitted for histopathology and immunohistochemistry.ResultsA trans‐costal surgical approach provided excellent visualisation of the adrenal mass and allowed for identification and ligation of associated vessels. Total surgical and anaesthesia time were 86 and 114 min, respectively. Several intraoperative (hypertension, tachycardia) and post‐operative (colic with tachycardia, tachypnea, large colon pelvic flexure impaction and nasogastric reflux) complications were encountered and managed successfully. Immunohistochemistry demonstrated positive labelling for synaptophysin and chromogranin A, confirming diagnosis of pheochromocytoma. The mare had recovered well at 6‐week recheck post‐operatively and returned to training at 6 months post‐operatively. No further clinical signs consistent with pheochromocytoma have been observed following removal.ConclusionsThe trans‐costal approach allowed for surgical removal of a pheochromocytoma in a mare. Surgical removal of adrenal masses in horses may be associated with complications yet was successfully performed without subsequent recurrence of clinical signs associated with tumour presence and return to athletic use in this mare.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful surgical removal of a pheochromocytoma in a mare via trans‐costal approach

O’Brien

Pezzanite

Acutt

et al. 2023

Equine Veterinary Journal

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“…Consequently, the posterior space would be compressed and more limited workspace further increases the difficulty of the surgical procedures. Moreover, after the lateroconal fascia incised longitudinally, the edge of lateroconal fascia blocks the sight like a “curtain”, which called curtain effect ( 5 , 6 ). In this study, for management of peritoneal tear and curtain effect, we described an efficient method called lateroconal fascia suspension (LFS) for junior surgeons.…”

Section: Introductionmentioning

confidence: 99%

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Alimu¹,

Dai²,

Huang³

et al. 2022

Transl Cancer Res TCR

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Background As the development of various imaging techniques, the incidental detection of renal masses is increasing. Laparoscopic partial nephrectomy (LPN) is the current standard of treatment for renal carcinoma. Though the retroperitoneal laparoscopic partial nephrectomy (RLPN) become the prior choice, the edge of lateroconal fascia blocks the sight and make operation more challenging. Methods Between October 2018 and December 2020, the clinical data of 28 cases diagnosed with renal cell carcinoma (RCC) in our hospital was collected and analyzed retrospectively. All patients underwent RLPN and for management of curtain effect, we performed lateroconal fascia suspension (LFS) procedure in all cases with prepared Hem-o-lock clip which bound with 2-0 suture. Results RLPN for renal tumor was successfully performed in all cases with no conversions to open surgery and other interruptions. In all cases, the free edge of lateroconal fascia and peritoneum partially blocked the sight of surgeon. We managed the curtain effect successfully and got a satisfying field of view for subsequent surgical procedure. The median operation time was 142 [interquartile range (IQR), 110–164] min, median estimated blood loss was 93 (IQR, 50–100) mL. Median warm ischemia time was 29 (IQR, 22–30) min. Conclusions LFS is useful for management of curtain effect. It is a simple, economical and less invasive technique and we can get better efficiency with little consumption.

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Lateroconal fascia suspension for management of peritoneal tear and “curtain” effect during retroperitoneal laparoscopic operations

Yin

Cui

et al. 2015

Int Urol Nephrol

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Consequences of Peritoneal Tears During Hand-assisted Retroperitoneoscopic Nephroureterectomy

Cited by 8 publications

References 7 publications

Successful surgical removal of a pheochromocytoma in a mare via trans‐costal approach

Successful surgical removal of a pheochromocytoma in a mare via trans‐costal approach

Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Lateroconal fascia suspension for management of peritoneal tear and “curtain” effect during retroperitoneal laparoscopic operations

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