Please use this identifier to cite or link to this item:
http://repositorio.unicamp.br/jspui/handle/REPOSIP/197616
Type: | Artigo de periódico |
Title: | Open Surgical Treatment Of Right-sided Adrenal Carcinomas >15 Cm. |
Author: | Ferreira, Ubirajara Nardi Pedro, Renato Matheus, Wagner Eduardo Prudente, Alessandro Mendonça Borges, Gustavo Rodrigues Netto, Nelson |
Abstract: | Adrenal carcinomas are rare and are associated with a very poor prognosis. The incidence is estimated to be 1 in 1.7 million which represents 0.02% of all cancers and 0.2% of all cancer mortality. The 5-year survival rate is 38%. The purpose of this paper is to present a single-institution experience in excising right-sided giant adrenal carcinomas, discussing the difficulties and the usage of special surgical devices to facilitate the procedure. During June 2001 to June 2003, 18 patients with right-sided adrenal tumors were treated at the State University of Campinas Hospital--UNICAMP. 4 out of the 18 patients presented lesions >15 cm, representing the study group. The mean age was 37 (range 26-65) years, 3 patients were younger than 35 years, and 2 patients were men. A right-sided extended subcostal incision was the surgical access in 1 patient (case 1) and a right-sided thoracoabdominal incision in the other 3 patients. Adrenal cortical carcinoma was the histological diagnosis according to the Weiss criteria; no positive surgical margin was detected, even in those patients with invasion of the hepatic capsule. The median follow-up period was 15 (range 6-30) months. A subcostal extended incision can accomplish broad exposure, if articulated costal retractors are available (used in liver transplantation), otherwise a thoracoabdominal incision is the best option. The most important feature of surgery is to accomplish an efficient hemostasis of the liver parenchyma. Suture and stitches are not suitable for minor vascular structures, and electrocauterization sometimes promotes hepatic lesions and does not provide bleeding control. Thus, the need for special hemostatic means is real, and they should be available in these situations. |
Subject: | Adrenalectomy Adrenocortical Carcinoma Adult Aged Diagnosis, Differential Female Follow-up Studies Humans Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Treatment Outcome |
Citation: | Urologia Internationalis. v. 78, n. 1, p. 46-9, 2007. |
Rights: | fechado |
Identifier DOI: | 10.1159/000096934 |
Address: | http://www.ncbi.nlm.nih.gov/pubmed/17192732 |
Date Issue: | 2007 |
Appears in Collections: | Unicamp - Artigos e Outros Documentos |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.