The anaesthetic management of a patient with a reninoma

Nicholson, John; Rayman, Gerry; Donaldson, Peter J.; Driver, I.

doi:10.1046/j.1365-2044.2003.03143.x

Cited by 8 publications

(9 citation statements)

References 14 publications

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“…The potential for hemodynamic fluctuations during the surgical resection of reninoma has not yet been well described. According to our observations, there were no significant fluctuations in blood pressure during the operation in any of the 9 cases, which is consistent with previous reports [29,30].…”

Section: Discussionsupporting

confidence: 93%

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Liu

Wang

et al. 2019

Med Sci Monit

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Background This article presents our experience in managing a rare kidney tumor – reninoma – by analyzing a relatively large series of cases from a single center. Material/Methods Nine cases of reninoma were reviewed. Clinical manifestations, imaging examinations, laboratory examinations, perioperative data, and pathological findings were summarized. A 58.8-month follow-up was performed to evaluate patient survival and recrudescence. Results The main clinical manifestations were hypertension, hypokalemia, headache, dizziness, nausea, vomiting, palpation, and sweating. Three patients had hypertensive end-organ damage, including brain hemorrhage, gestation termination, and grade III ocular fundus changes. All patients underwent retroperitoneal laparoscopic partial nephrectomy successfully. The mean warm ischemic time was 23.4 min. The median operation time was 95.1 min, with a median estimated blood loss of 60 ml. The median hospital stay was 6 days. No serious intraoperative or postoperative complications occurred. The histology and electron microscopy findings confirmed the diagnosis of reninoma in all cases. After 58.8 months of follow-up, symptoms involving hypertension were relieved in all patients, and no tumor recurrence or metastasis was detected. Conclusions Reninoma may have severe consequences despite being a benign tumor. Retroperitoneal laparoscopic partial nephrectomy is a feasible and effective method for the surgical removal of reninoma. Multidisciplinary cooperation plays an important role in improving the diagnosis and enabling the early surgical treatment of reninoma. Especially in cases of reninoma with moderate and high RENAL scores, an accurate diagnosis of reninoma based on multidisciplinary cooperation facilitates the selection of less invasive surgical approaches.

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Section: Discussionsupporting

confidence: 93%

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Liu

Wang

et al. 2019

Med Sci Monit

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“…Computed tomography (CT) scans were performed in 45 cases, and a renal lesion was demonstrated in all cases [4,9,11,15,18,19,21-25,27,30-32,34,35,38,40,42,43,45,47,50,51,53,54,57,59,61 -64,67, 69]. CT scans may be particularly sensitive at detecting the tumor, as shown in studies demonstrating that venous catheterization revealed lateralization in only half of 25 subjects with a lesion documented by CT [11,18,21,30,31,42,53,54,57,61,67]. Both MRI and CT scans are therefore highly effective at determining the presence of a JGA tumor.…”

Section: Discussionmentioning

confidence: 91%

Reninoma: case report and literature review

Wong¹,

Hsu²,

Perlroth³

et al. 2008

Journal of Hypertension

135

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Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin. We describe a case of reninoma and provide a review of the literature, with a discussion emphasizing the diagnostic evaluation for such patients. The subject had persistent elevation of both plasma renin activity (PRA) and aldosterone. Imaging studies revealed the presence of a lesion in the renal cortex, which was further identified as a renin-producing lesion via selective venous catheterization following administration of an angiotensin-converting enzyme inhibitor (ACE-I). Following partial nephrectomy, the PRA and plasma aldosterone levels declined rapidly and the blood pressure and potassium supplementation requirements normalized. This case demonstrates the utility of both appropriate imaging studies and selective venous catheterization following provocative administration of an ACE-I for diagnosis.

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“…Thus, perioperative hemodynamic management is very important for patients who undergo surgery for the removal of a reninoma. In addition, to our best knowledge, case reports regarding the anesthetic management of a reninoma are very rare [ 4 ]. Here, we report the anesthetic management of a patient who underwent percutaneous computed tomography (CT)-guided radiofrequency ablation for the destruction of a reninoma, particularly focusing on postoperative hypotension.…”

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confidence: 99%

Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma: a case report

Gil

Han

et al. 2015

Korean J Anesthesiol

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A reninoma is an uncommon, benign, renin-secreting juxtaglomerular cell tumor that causes secondary hypertension in young patients. This hypertension is treated by tumor resection. Except for increased levels of plasma renin and angiotensin I and II, the other physical and laboratory examinations and electrocardiographs were within normal limits upon admission of a 19-year-old woman with a reninoma. For percutaneous computed tomography-guided radiofrequency ablation, general anesthesia was induced by thiopental sodium and rocuronium bromide and maintained with servoflurane (2-4 vol%) and oxygen. The operation ended uneventfully in hemodynamic stability. However, the patient complained of dizziness while sitting 5 hours after the operation, and hypotension was diagnosed. After aggressive normal saline (1 L) infusion over 30 min, the hypotension was corrected and the patient recovered without any other surgical complications. Here, we report the anesthetic management of a patient who underwent percutaneous computed tomography-guided radiofrequency ablation for reninoma destruction, particularly focusing on postoperative hypotension.

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The anaesthetic management of a patient with a reninoma

Cited by 8 publications

References 14 publications

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Minimally Invasive Surgery-Based Multidisciplinary Clinical Management of Reninoma: A Single-Center Study

Reninoma: case report and literature review

Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma: a case report

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