Retroperitoneoscopic adrenalectomy in an infant with adrenocortical virilizing tumor

Tobias-Machado, Marcos; Cartum, Jairo; Santos-Machado, Telma Murias; Gaspar, Heloisa Amaral; Simoes, Alexandre Sibanto; Cruz, Ricardo; Rodrigues, Renata de Oliveira Batista; Juliano, Roberto Vaz; Wroclawski, Eric Roger

doi:10.1590/s1516-31802002000300007

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…8 Ciftci et al reported four cases of recurrence after complete surgical resection. 12 Laparoscopic adrenalectomy enables complete resection of both benign and malignant adrenal masses, 1,13,14 and provides good results. Lopes et al treated nine children with adrenocortical tumor via laparoscopic adrenalectomy, with no perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

Adrenocortical tumor with precocious puberty in a 2‐month‐old girl

Marret

Raffoul

Ribault

et al. 2015

Pediatrics International

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Adrenocortical tumor is a rare childhood tumor with a median age at onset of 3.2 years. Virilization is the most common sign. Laparotomy is the reference treatment and has a favorable course. The diagnosis of adrenal tumor can be difficult. The main parameters of malignant tumors are size and metastasis. Analysis of TP53 mutation can facilitate final diagnosis. We report a case of virilizing adrenal tumor that developed in a 2-month-old girl, and which was treated with laparoscopic adrenalectomy.

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Section: Discussionmentioning

confidence: 99%

Adrenocortical tumor with precocious puberty in a 2‐month‐old girl

Marret

Raffoul

Ribault

et al. 2015

Pediatrics International

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“…Studying the overall surgical experiences of the three groups, general surgeons typically use a transperitoneal approach, sometimes with the patient supine; urologists, who typically have more anatomical experience in the retroperitoneal space, use both approaches. Although feasible [25] the retroperitoneoscopic approach in the paediatric patient represents a somewhat demanding access to the adrenal gland because of the very limited working space in young patients. To have an optimal surgical area and adequate working space the vast majority of surgeons prefer the transperitoneal approach for LA in paediatric patients.…”

Section: Different Approaches For Different Surgeons?mentioning

confidence: 99%

Laparoscopic treatment of adrenal diseases: 10 years on

et al. 2003

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Since it was initially described in 1992 laparoscopic adrenalectomy (LA) has been gaining popularity amongst urologists and its range of applications has progressively widened. Ten years after the first report of LA this type of operation is presently considered to be the ‘standard of care’ for most adrenal diseases requiring surgery. We define the current role of laparoscopy in the management of surgical adrenal diseases, using a Medline search (1997–2002) to assess reports of LA, focusing on indications, approaches (transperitoneal and retroperitoneoscopic) and comparative analyses, taking particular care to evaluate operative duration, rate of conversion and transfusion, complications and hospital stay. With both approaches LA is safe and effective and, when compared with open surgery, offers the same functional results with all the advantages of minimally invasive surgery. We conclude that LA based on either approach should be considered the treatment of choice for benign adrenal lesions. Although very promising, conservative surgery and LA should still be evaluated in cases of malignancy.

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“…However, the initial application of extraperitoneal videoendoscopic surgery presents greater technical difficulty, mainly due to a smaller working space, lower lightning and the spatial orientation, which are responsible for a larger learning curve (6)(7)(8). The issue of working space is relative and directly associated with a good peritoneal detachment and proper installation of the ports, being feasible even in children (17,18). Concerning the spatial orientation, the optics must be always kept in a position where it is possible to observe the posterior muscles in horizontal position, thus allowing anatomical parameters to be identified.…”

Section: Commentsmentioning

confidence: 99%

“…We believe that the expansion of the extraperitoneal space with the aid of the atraumatic balloon -either hand-made, industrialized, direct viewing-guided or not -is recommendable since it enlarges the surgical field in areas that cannot be reached by the finger, reducing the need of forceps dissection (3,14,17). The use of the balloon trocar has the advantage of allowing the visualization of structures, especially the renal pedicle, during the expansion.…”

Section: Commentsmentioning

confidence: 99%

Videoendoscopic surgery by extraperitoneal access

Tobias-Machado¹,

Juliano²,

Gaspar³

et al. 2003

Int. braz j urol.

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Laparoscopic surgery in urology is definitely incorporated to the techniques of minimally invasive treatment for urogenital diseases. Though the classic access to organs in the urinary tract is extraperitoneal, this access has not been prioritized when the videoendoscopic technique is used. In Brazil, few groups use this approach and little has been discussed about its true practical applicability. The authors intended to discuss the main technical aspects and criteria for indication, reported though the improvement achieved in a 5-year period with 150 operated cases. A review of the literature shows that the worldly acceptance of the extraperitoneal endoscopic approach is increasing. Nevertheless, there are no evidences that the extraperitoneal access is superior to the transperitoneal route. Thus, the choice depends basically on the surgeon's preference. Major advantages are the immediate access to the renal hilum and isolation of peritoneal structures. Employing this access is useful when one suspects that significant peritoneal adherences could prevent the surgical act or when one wishes to preserve the integrity of the peritoneal cavity.

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Retroperitoneoscopic adrenalectomy in an infant with adrenocortical virilizing tumor

Abstract: We performed the first laparoscopic resection using retroperitoneal access for the treatment of an adrenocortical virilizing tumor in a pediatric patient. We believe that retroperitoneoscopic access is a viable and promising option for the treatment of adrenal tumors in children.

Cited by 8 publications

References 3 publications

Adrenocortical tumor with precocious puberty in a 2‐month‐old girl

Adrenocortical tumor with precocious puberty in a 2‐month‐old girl

Laparoscopic treatment of adrenal diseases: 10 years on

Videoendoscopic surgery by extraperitoneal access

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