Predictive factors and radiological findings of adrenohepatic adhesion during laparoscopic adrenalectomy

Katsuhiro Ito; Hiromasa Araki; Toshihiro Uchida; Yumi Manabe; Yu Miyazaki; Haruki Itoh; Mutsuki Mishina; Hiroshi Okuno

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자료유형: 학술저널

저자정보: Katsuhiro Ito (National Hospital Organization Kyoto Medical Center) Hiromasa Araki (National Hospital Organization Kyoto Medical Center) Toshihiro Uchida (National Hospital Organization Kyoto Medical Center) Yumi Manabe (National Hospital Organization Kyoto Medical Center) Yu Miyazaki (National Hospital Organization Kyoto Medical Center) Haruki Itoh (National Hospital Organization Kyoto Medical Center) Mutsuki Mishina (National Hospital Organization Kyoto Medical Center) Hiroshi Okuno (National Hospital Organization Kyoto Medical Center)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.61 No.3

발행연도: 2020.1

수록면: 277 - 283 (7page)

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Purpose: This retrospective study aimed to identify predictive factors and imaging features of adrenohepatic adhesion found during laparoscopic right adrenalectomy. Materials and Methods: Altogether, 77 patients underwent laparoscopic right adrenalectomy between January 2005 and December 2018. Adrenohepatic adhesion was defined as strict adhesion that required either partial adrenalectomy with coagulation of residual tissue or partial hepatectomy to accomplish complete resection. We assessed their surgical video records to determine if adrenohepatic adhesion was present. Age, sex, body mass index, tumor size, tumor diagnosis and radiological findings (attachment between the liver and the adrenal gland, diameters of the right and left adrenal veins and its ratio) were evaluated as preoperative variables. Results: Adrenohepatic adhesion was present in 11 of the 77 patients (14.3%). Age, sex, and body mass index were not statistically significant factors. Tumor size was significantly small in adhesion group (14.2 mm vs. 25.9 mm, p=0.02). Attachment to the liver and adrenal gland was frequently seen regardless of the adhesion. The mean right/left adrenal veins diameters ratio was significantly lower in the adhesion group (0.8 vs. 1.1, p=0.01). Multivariate logistic regression analysis demonstrated the right/left adrenal veins diameters ratio was the only significant predictor of adhesion. The sensitivity, specificity, negative predictive value and positive predictive value were 0.82, 0.76, 0.43, and 0.95 respectively when the optimal cutoff value for the ratio was 0.9 (area under the curve, 0.75; 95% confidence interval, 0.60–0.90). Conclusions: The right/left adrenal veins diameters ratio was possible predictor of adrenohepatic adhesion.

#Adrenalectomy #Adrenal glands #Laparoscopy #Radiography #Tissue adhesions

참고문헌 (22)

참고문헌 신청

Honoré LH / 1976 / Combined adrenorenal fusion and adrenohepatic adhesion : a case report with review of the literature and discussion of pathogenesis / J Urol 115:323~325

Sugimoto M / 2013 / Cellular intermingling between adrenal gland and liver : an infrequent cause of incomplete resection at right adrenalectomy / J Endourol 27:804~808

Tanguay S / 1996 / Therapy of locally recurrent renal cell carcinoma after nephrectomy / J Urol 155:26~29

Sandhu SS / 2005 / Surgical excision of isolated renal-bed recurrence after radical nephrectomy for renal cell carcinoma / BJU Int 95:522~525

Krane LS / 2008 / A four-step technique of robotic right adrenalectomy : initial experience / BJU Int 101:1289~1292

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Katsuhiro Ito

소속기관 Tenri Hospital

주요연구분야 의약학 > 임상의학 > 비뇨기과학

논문수 3 이용수 2

Hiromasa Araki