Perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma

Pisarska, Magdalena; Pędziwiatr, Michał; Budzyński, Andrzej

doi:10.21037/gs.2016.09.05

Cited by 27 publications

(28 citation statements)

References 61 publications

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“…There is increase in average time for surgery and hence may cause surgeons' fatigue. The most important problem associated with these surgeries from an anesthetists' perspective is hemodynamic instability of the patient during laparoscopic surgeries [4] . The mean arterial pressure generally decreases after induction of anaesthesia but there is increase in MAP after peritoneal insufflation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Effect of Infusion of Dexmedetomidine on Attenuation of Hemodynamic Response During Laparoscopic Surgeries

Yennawar¹

2017

jmscr

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Section: Introductionmentioning

confidence: 99%

Evaluation of Effect of Infusion of Dexmedetomidine on Attenuation of Hemodynamic Response During Laparoscopic Surgeries

Yennawar¹

2017

jmscr

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“…Nesse caso optou--se pela ressecção cirúrgica da massa após avaliação da vascularização, contorno irregular da massa, posicionamento deslocando a veia cava caudal ventrolateralmente e o tamanho (4 cm de diâmetro aproximadamente) indicando malignidade. Em humanos a adrenalectomia é indicada somente em massas acima de 4-6 cm ou quando há invasão vascular, porém em veterinária, apesar de estudos que ajudam no manejo clínico, não há consenso sobre as recomendações ao se diagnosticar massa em adrenal [3,18].…”

Section: Discussionunclassified

“…Em estudo recente observou associação da hipertensão ao crescimento da massa adrenal durante acompanhamento [3]. Em alguns relatos observou-se instabilidade anestésica em excisão cirúrgica de feocromocitoma em humanos, decorrente da liberação de catecolaminas [11,18].…”

Section: Discussionunclassified

Incidental Adrenocortical Carcinoma in Dogs: Clinical, Tomographic and Histopathological

Pelegrini

Lima

Burema

et al. 2019

Acta Scientiae. Vet.

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Background: Adrenal incidentalomas are masses accidentally discovered during imaging examinations performed when there is no suspicion of adrenal disease. Even with a low prevalence, it is important to perform a reliable evaluation observing biological behavior and determining whether the hormonal activity is stimulated. Frequently, these masses are not functional, but in some cases, there is increased cortisol activity, and patients with adrenal incidentalomas may present hyperadrenocorticism. This report aims to describe the clinical, tomographic, and histopathological aspects of a case of adrenal incidentaloma detected in a routine abdominal ultrasound. Case: An 8-year-old, male, maltese dog with occasional emesis, halitosis, claudication of the left pelvic limb, and previous compensated and untreated cardiomyopathy was treated at the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT). Physical examination revealed arterial hypertension and claudication, with the positive posterior drawer test suggesting rupture of the cruciate ligament. The blood count showed no alteration, and the serum biochemistry revealed a slight increase in the activity of alanine aminotransferase. In order to investigate this increase, an abdominal ultrasound was performed. Slight hepatomegaly and a heterogeneous mass of irregular edges were observed with a moderate and difficult-to-delimit vascularization of the adrenal gland. Left knee radiography raised the suspicion of rupture of the cranial cruciate ligament due to the cranial displacement of the tibia in relation to the femur. Computed tomography was performed to define the extent and delimitation of the mass, which was compatible with a tumor of the right adrenal gland characterized by the visualization of an abdominal mass between the kidneys, extending from the hepatic region to the cranial pole of the left kidney. On follow-up, the patient was reported to have diarrhea with black stools, and a lowdose dexamethasone suppression test was ordered. Unilateral adrenalectomy was recommended due to the suspicion of pheochromocytoma. During the surgical procedure, the mass adhered to the abdominal wall and the diaphragm resulting in the death of the animal. Histopathological analysis revealed a cellular proliferation of cortical adrenal cells forming multiple cell nests separated by a small amount of fibrovascular stroma. Proliferated cells were polyhedral, with densely eosinophilic cytoplasm and well-defined edges, and were occasionally vesicular. They had globular nuclei, slightly stained chromatin, and inconspicuous nucleoli. Pleomorphism, anisocytosis, and anisokaryosis were accentuated, and eight mitosis figures were observed in ten high-power fields (40×), leading to a diagnosis of adrenocortical carcinoma. Discussion: When there is no suspicion or characteristic clinical sign, and adrenal growth is observed on imaging examination, the finding may be called an incidentaloma. Here, the incidentaloma was a non-functional adrenal carcinoma, because the tests...

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“…Owing to the close international collaboration we are presenting in this issue 12 reports from leading experts in the field focused on selected hot topics in endocrine surgery: intraoperative neural monitoring (IONM) in thyroid surgery (1,2), safety of energy based devices (EBD) for hemostasis in thyroid surgery (3), utility of BRAF V600E mutation for prognostication of papillary thyroid cancer (PTC) recurrence (4), rare cases of PTC associated with thyroid Langerhans cell histiocytosis (5), management of thyroid cancer with tracheal invasion (6), utility of indocyanine green-enhanced fluorescence to assess parathyroid perfusion during thyroidectomy (7), value of iPTH assay for early prognostication of postoperative hypocalcemia (8), risk factors for perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma (9), utility of laparoscopic sleeve gastrectomy (LSG) for the treatment of diabetes mellitus type 2 (10), innovative solutions in bariatric surgery (11), including new endoscopic procedures for diabetes mellitus type 2 and obesity treatment (12).…”

mentioning

confidence: 99%

“…Such approach does not carry additional risk also in larger tumors. To minimize morbidity and mortality a close cooperation between the surgeon and anesthetist is mandatory in every patient with suspected or confirmed pheochromocytoma (9).…”

mentioning

confidence: 99%

New techniques and technologies for the treatment of surgical endocrine diseases

Barczyński¹,

Dionigi²

2016

Gland Surg.

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Perioperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma

Cited by 27 publications

References 61 publications

Evaluation of Effect of Infusion of Dexmedetomidine on Attenuation of Hemodynamic Response During Laparoscopic Surgeries

Evaluation of Effect of Infusion of Dexmedetomidine on Attenuation of Hemodynamic Response During Laparoscopic Surgeries

Incidental Adrenocortical Carcinoma in Dogs: Clinical, Tomographic and Histopathological

New techniques and technologies for the treatment of surgical endocrine diseases

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