副腎髄質腫瘍に対する外科
当院では1992年７月から2011年12月までに副腎腫瘍171名（うち両側症例８名）に対し腹腔鏡下副腎摘除術を施行している。このうち，副腎褐色細胞腫27例の平均手術時間は166分，平均出血量は48.7mlであり，１例術後合併症として誤嚥による心肺停止症例（後に蘇生）を経験した以外に，重大な術中合併症，開放手術への転換，周術期死亡などは認めていない。また，副腎腫瘍摘除術術後再発をきたした悪性褐色細胞腫症例３例（他院で初回手術施行症例２例含む）の治療を経験した。うち２例は後腹膜腫瘍摘除術後に補助療法としてCVD療法を４クール施行した。再発腫瘍摘除術後観察期間４，16，19ヵ月で現在再発認めていない...
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| Published in | 日本内分泌・甲状腺外科学会雑誌 Vol. 29; no. 1; pp. 31 - 38 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本内分泌外科学会・日本甲状腺外科学会
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-9545 |
| DOI | 10.11226/jaesjsts.29.1_31 |
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| Abstract | 当院では1992年７月から2011年12月までに副腎腫瘍171名（うち両側症例８名）に対し腹腔鏡下副腎摘除術を施行している。このうち，副腎褐色細胞腫27例の平均手術時間は166分，平均出血量は48.7mlであり，１例術後合併症として誤嚥による心肺停止症例（後に蘇生）を経験した以外に，重大な術中合併症，開放手術への転換，周術期死亡などは認めていない。また，副腎腫瘍摘除術術後再発をきたした悪性褐色細胞腫症例３例（他院で初回手術施行症例２例含む）の治療を経験した。うち２例は後腹膜腫瘍摘除術後に補助療法としてCVD療法を４クール施行した。再発腫瘍摘除術後観察期間４，16，19ヵ月で現在再発認めていない。最後に，多発性内分泌腺腫症２型（以下MEN2），von Hippel-Lindau病（以下VHL）に対する部分切除術の現状について文献的に考察，報告する。 |
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| AbstractList | 当院では1992年７月から2011年12月までに副腎腫瘍171名（うち両側症例８名）に対し腹腔鏡下副腎摘除術を施行している。このうち，副腎褐色細胞腫27例の平均手術時間は166分，平均出血量は48.7mlであり，１例術後合併症として誤嚥による心肺停止症例（後に蘇生）を経験した以外に，重大な術中合併症，開放手術への転換，周術期死亡などは認めていない。また，副腎腫瘍摘除術術後再発をきたした悪性褐色細胞腫症例３例（他院で初回手術施行症例２例含む）の治療を経験した。うち２例は後腹膜腫瘍摘除術後に補助療法としてCVD療法を４クール施行した。再発腫瘍摘除術後観察期間４，16，19ヵ月で現在再発認めていない。最後に，多発性内分泌腺腫症２型（以下MEN2），von Hippel-Lindau病（以下VHL）に対する部分切除術の現状について文献的に考察，報告する。 |
| Author | 滝澤, 奈恵 乾, 秀和 河, 源 川端, 和史 飯田, 剛嗣 原田, 二郎 松田, 公志 木下, 秀文 |
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| References | 7. Kazaryan AM, Marangos IP, Rosseland AR, et al.:Laparoscopic adrenalectomy:Norwegian single-center experience of 242 procedures. J Laparoendosc Adv Surg Tech A 19:181-189, 2009 1. Suzuki K, Kageyama S, Ueda D, et al.:Laparoscopic adrenalectomy:clinical experience with 12 cases. J Urol 150:1099-1102, 1993 11. Li ML, Fitzgerald PA, Price DC, et al.:Iatrogenic pheochromocytomatosis:a previously unreported result of laparoscopic adrenalectomy. Surgery 130:1072-1077, 2001 22. Lee JE, Curley SA, Gagel RF, et al.:Cortical-sparing adrenalectomy for patients with bilateral pheochromocytoma. Surgery 120:1064-1070, 1996 14. Jirari A, Charpentier A, Popescu S, et al.:A malignant primary cardiac pheochromocytoma. Ann Thorac Surg 68:565-566, 1999 23. Okamoto T, Obara T, Ito Y, et al.:Bilateral adrenalectomy with autotransplantation of adrenocortical tissue or unilateral adrenalectomy:treatment options for pheochromocytomas in multiple endocrine neoplasia type 2A. Endocr J 43:169-175, 1996 2. Kercher KW, Park A, Matthews BD, et al.:Laparoscopic adrenalectomy for pheochromocytoma. Surg Endosc 16:100-102, 2002 21. Sanford TH, Storey BB, Linehan WM, et al.:Outcomes and timing for intervention of partial adrenalectomy in patients with a solitary adrenal remnant and history of bilateral phaeochromocytomas. BJU Int 107:571-575, 2011 18. VHL family alliance:Information for Health Care Professionals. Section 5:Suggested Screening Guidelineshttp://www.vhl.org/handbook/vhlhb4.php Accessed 2012 Jan 10 9. van Heerden JA, Roland CF, Carney JA, et al.:Long-term evaluation following resection of apparently benign pheochromocytoma(s)/paraganglioma(s). World J Surg 14:325-329, 1990 12. Walz MK, Alesina PF, Wenger FA, et al.:Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas:results of 161 tumors in 126 patients. World J Surg 30:899-908, 2006 19. Carney JA, Lloyd RV : Adrenal. : Mills SE (eds), Hisotology For Pathologists. 3rd ed, Lippincott Williams & Wilkins, Philadelphia, 2007, p1167-1188 13. Shen WT, Grogan R, Vriens M, et al.:One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy. Arch Surg 145:893-897, 2010 10. Mornex R, Badet C, Peyrin L:Malignant pheochromocytoma:a series of 14 cases observed between 1966 and 1990. J Endocrinol Invest 15:643-649, 1992 3. Kim AW, Quiros RM, Maxhimer JB, et al.:Outcome of laparoscopic adrenalectomy for pheochromocytomas vs aldosteronomas. Arch Surg 139:526-529;discussion 529-531, 2004 24. Brunt LM, Lairmore TC, Doherty GM, et al.:Adrenalectomy for familial pheochromocytoma in the laparoscopic era. Ann Surg 235:713-720;discussion 720-721, 2002 20. Brauckhoff M, Stock K, Stock S, et al.:Limitations of intraoperative adrenal remnant volume measurement in patients undergoing subtotal adrenalectomy. World J Surg 32:863-872, 2008 15. Asari R, Scheuba C, Kaczirek K, et al.:Estimated risk of pheochromocytoma recurrence after adrenal-sparing surgery in patients with multiple endocrine neoplasia type 2A. Arch Surg 141:1199-1205, 2006 4. Toniato A, Boschin I, Bernante P, , et al.:Laparoscopic adrenalectomy for pheochromocytoma:is it really more difficult?Surg Endosc 21:1323-1326, 2007 16. Adler JT, Meyer-Rochow GY, Chen H, et al.:Pheochromocytoma:Current Approaches and Future Directions. Oncologist 13:779-793, 2008 25. Rodriguez JM, Balsalobre M, Ponce JL, et al. : Pheochromocytoma in MEN 2A syndrome. Study of 54 patients. World J Surg 32:2520-2526, 2008 17. Amar L, Bertherat J, Baudin E, et al. Genetic testing in pheochromocytoma or functional paraganglioma. J Clin Oncol 1 23:8812-8818, 2005 5. Kasahara T, Nishiyama T, Takahashi K:Laparoscopic adrenalectomy for pheochromocytoma:evaluation of experience and strategy at a single institute. BJU Int 103:218-222, 2009 6. Tatsugami K, Eto M, Hamaguchi M, et al.:What affects the results of a laparoscopic adrenalectomy for pheochromocytoma? Evaluation with respect to intraoperative blood pressure and state of tumor. J Endourol 23:101-105, 2009 8. Li QY, Li F:Laparoscopic adrenalectomy in pheochromocytoma:retroperitoneal approach versus transperitoneal approach. J Endourol 24:1441-1445, 2010 |
| References_xml | – reference: 24. Brunt LM, Lairmore TC, Doherty GM, et al.:Adrenalectomy for familial pheochromocytoma in the laparoscopic era. Ann Surg 235:713-720;discussion 720-721, 2002 – reference: 11. Li ML, Fitzgerald PA, Price DC, et al.:Iatrogenic pheochromocytomatosis:a previously unreported result of laparoscopic adrenalectomy. Surgery 130:1072-1077, 2001 – reference: 21. Sanford TH, Storey BB, Linehan WM, et al.:Outcomes and timing for intervention of partial adrenalectomy in patients with a solitary adrenal remnant and history of bilateral phaeochromocytomas. BJU Int 107:571-575, 2011 – reference: 15. Asari R, Scheuba C, Kaczirek K, et al.:Estimated risk of pheochromocytoma recurrence after adrenal-sparing surgery in patients with multiple endocrine neoplasia type 2A. Arch Surg 141:1199-1205, 2006 – reference: 6. Tatsugami K, Eto M, Hamaguchi M, et al.:What affects the results of a laparoscopic adrenalectomy for pheochromocytoma? Evaluation with respect to intraoperative blood pressure and state of tumor. J Endourol 23:101-105, 2009 – reference: 12. Walz MK, Alesina PF, Wenger FA, et al.:Laparoscopic and retroperitoneoscopic treatment of pheochromocytomas and retroperitoneal paragangliomas:results of 161 tumors in 126 patients. World J Surg 30:899-908, 2006 – reference: 13. Shen WT, Grogan R, Vriens M, et al.:One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy. Arch Surg 145:893-897, 2010 – reference: 4. Toniato A, Boschin I, Bernante P, , et al.:Laparoscopic adrenalectomy for pheochromocytoma:is it really more difficult?Surg Endosc 21:1323-1326, 2007 – reference: 1. Suzuki K, Kageyama S, Ueda D, et al.:Laparoscopic adrenalectomy:clinical experience with 12 cases. J Urol 150:1099-1102, 1993 – reference: 5. Kasahara T, Nishiyama T, Takahashi K:Laparoscopic adrenalectomy for pheochromocytoma:evaluation of experience and strategy at a single institute. BJU Int 103:218-222, 2009 – reference: 23. Okamoto T, Obara T, Ito Y, et al.:Bilateral adrenalectomy with autotransplantation of adrenocortical tissue or unilateral adrenalectomy:treatment options for pheochromocytomas in multiple endocrine neoplasia type 2A. Endocr J 43:169-175, 1996 – reference: 9. van Heerden JA, Roland CF, Carney JA, et al.:Long-term evaluation following resection of apparently benign pheochromocytoma(s)/paraganglioma(s). World J Surg 14:325-329, 1990 – reference: 18. VHL family alliance:Information for Health Care Professionals. Section 5:Suggested Screening Guidelineshttp://www.vhl.org/handbook/vhlhb4.php Accessed 2012 Jan 10 – reference: 22. Lee JE, Curley SA, Gagel RF, et al.:Cortical-sparing adrenalectomy for patients with bilateral pheochromocytoma. Surgery 120:1064-1070, 1996 – reference: 14. Jirari A, Charpentier A, Popescu S, et al.:A malignant primary cardiac pheochromocytoma. Ann Thorac Surg 68:565-566, 1999 – reference: 20. Brauckhoff M, Stock K, Stock S, et al.:Limitations of intraoperative adrenal remnant volume measurement in patients undergoing subtotal adrenalectomy. World J Surg 32:863-872, 2008 – reference: 19. Carney JA, Lloyd RV : Adrenal. : Mills SE (eds), Hisotology For Pathologists. 3rd ed, Lippincott Williams & Wilkins, Philadelphia, 2007, p1167-1188 – reference: 8. Li QY, Li F:Laparoscopic adrenalectomy in pheochromocytoma:retroperitoneal approach versus transperitoneal approach. J Endourol 24:1441-1445, 2010 – reference: 16. Adler JT, Meyer-Rochow GY, Chen H, et al.:Pheochromocytoma:Current Approaches and Future Directions. Oncologist 13:779-793, 2008 – reference: 2. Kercher KW, Park A, Matthews BD, et al.:Laparoscopic adrenalectomy for pheochromocytoma. Surg Endosc 16:100-102, 2002 – reference: 3. Kim AW, Quiros RM, Maxhimer JB, et al.:Outcome of laparoscopic adrenalectomy for pheochromocytomas vs aldosteronomas. Arch Surg 139:526-529;discussion 529-531, 2004 – reference: 7. Kazaryan AM, Marangos IP, Rosseland AR, et al.:Laparoscopic adrenalectomy:Norwegian single-center experience of 242 procedures. J Laparoendosc Adv Surg Tech A 19:181-189, 2009 – reference: 17. Amar L, Bertherat J, Baudin E, et al. Genetic testing in pheochromocytoma or functional paraganglioma. J Clin Oncol 1 23:8812-8818, 2005 – reference: 25. Rodriguez JM, Balsalobre M, Ponce JL, et al. : Pheochromocytoma in MEN 2A syndrome. Study of 54 patients. World J Surg 32:2520-2526, 2008 – reference: 10. Mornex R, Badet C, Peyrin L:Malignant pheochromocytoma:a series of 14 cases observed between 1966 and 1990. J Endocrinol Invest 15:643-649, 1992 |
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| SubjectTerms | 副腎腫瘍 副腎部分切除術 悪性褐色細胞腫 腹腔鏡下副腎摘除術 褐色細胞腫 |
| Title | 副腎髄質腫瘍に対する外科 |
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