Téma: 

Laparoscopic transperitoneal adrenalectomy

Ján Ľupták, Michael Vraný, Ján Švihra, Ján Kliment

Objective: Laparoscopic adrenalectomy has become standard treatment for adrenal diseases in the last ten years. The aim of this study was retrospective analysis of our 5-year experience with laparoscopic adrenalectomy.
Material and metdhods: From March 2001 to December 2005, we performed 33 laparoscopic adrenalectomies (16 right, 17 left) for adrenal tumours by a transperitoneal approach in 31 patients (16 men, 15 women) with mean age of 47,5 years (range 36 to 73). Bilateral adrenalectomy were performed simultaneously in two (6,4 %) patients (one patient after failed transsphenoidal operation of hypophysis for central Cushing syndrome, one patient suffered from CT suspected bilateral adrenal gland metastasis). Concomitant hypertension occured in 12 (38,7 %) patients and 14 (45,2 %) had previous abdominal cavity operation.
Results: The laparoscopic procedure was succesfully completed in 28 (90,3 %) from 31 patients. The average adrenal tumor size was 4,1 cm (range 1,1 - 8,7). All procedures required 4 trocars and a mean operative time of 138 min (47 - 280 min.), while in the second half of the patient the operating time decreased about one third. Blood transfusions were performed in three (9,7 %) cases. One patient (3,2 %) with heamorrhage due to vena cava vein injury and one (3,2 %) with bleeding from adrenalectomy bed underwent conversion to an open surgery. Third patient with bleeding from adrenalectomy bed was treated via laparoscopic approach. Histological evaluation of the extracted adrenal glands revealed following: 14 (42,5 %) nodular hyperplasia, 7 (21,2 %) pheochromocytomas, 7 (21,2 %) adenomas, 3 (9,1 %) myolipomas, l (3 %) ganglioneuroma and l (3 %) metastasis of renal cell cancer.
Conclusions: Laparoscopic adrenalectomy is safe and effective surgical modality which has become the surgical procedure of first choice for adrenal removal. Laparoscopic approach appears to be a minimally invasive and safe therapeutic option for adrenal tumours. This technique has low morbidity, low postoperative analgesic requirements and shorter hospital stay.

Ročník 2006  Témy časopisu Clinical urology 1 / 2006

CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ján Kliment, CSc.

MEMBERS OF THE EDITORIAL BOARD
prof. Andrzej Borówka, M.D., PhD.
prof. MUDr. Ján Breza, DrSc.
prof. MUDr. Peter Bujdák, PhD.
prof. MUDr. Tomáš Hanuš, DrSc.
doc. MUDr. Ladislav Jarolím, CSc.
doc. MUDr. Ján Ľupták, PhD.
doc. MUDr. Jozef Marenčák, PhD.
doc. MUDr. Ivan Minčík, PhD.
prof. MUDr. Dalibor Ondruš, DrSc.
prof. Imre Romics, M.D., PhD.
doc. MUDr. Vladimír Študent, PhD.
prof. MUDr. Ján Švihra, PhD.
prof. MUDr. Ladislav Valanský, PhD.
doc. MUDr. František Záťura, PhD.
MUDr. Peter Zvara, PhD.

PROFESSIONAL EDITOR
prof. MUDr. Ján Švihra, PhD.

EDITOR-IN-CHIEF
Ing. Danica Paulenová
e-mail: paulenova@amedi.sk

GRAPHIC LAYOUT AND TYPESETTING
Lucia Vecseiová
e-mail: dtp@amedi.sk

MARKETING MANAGER
Ing. Dana Chodasová
mobil: 0903 224 625
e-mail: marketing@amedi.sk

ECONOMY AND SUBSCRIPTIONS
Ing. Mária Štecková
telefón: 02/55 64 72 48
mobil: 0911 117 949
e-mail: ekonom@amedi.sk

LANGUAGE PROOFREADING
Mgr. Eva Doktorová

PROOFREADING OF ENGLISH TEXTS
Mgr. Jana Bábelová

SECTIONS

OVERVIEW PAPERS
The latest knowledge on disease and disease groups aetiology, pathogenesis, diagnoses and therapy. Maximum extent is 7 pages of text (font ARIAL or TIMES, font size 12, line spacing 1.5). In case of more extensive theme elaboration it is possible to divide the paper to several parts after agreement with editorial office.

ORIGINAL PAPERS
Structuring: introduction, clinical group and methods, results, discussion, conclusion, bibliography

DIAGNOSTIC AND THERAPEUTICAL ALGORITHMS
Diagnosis and therapy processed into tables and schemes, with minimum text, with emphasis on conciseness and clarity.

CASE STUDY
Maximum extent is 3 pages. Structuring: summary, case study, conclusion, bibliography.

MISCELLANEOUS
Reaction to overview articles, news in the field of diagnostics, therapy, trial results (maximum 3 pages), reports from professional events, abstracts from scientific work published abroad, not older than 1 year. Maximum extend is 1 page. Title of the paper in Slovak/Czech, authors, workplace, then title of the paper in English with full citation.


MANUSCRIPT ELABORATION

Write the paper on computer in any common text editor.
write full length of lines (do not use ENTER at the end of a line)
- do not arrange text into columns
- do not do page make-up, put tables at the end of the paper
- distinguish precisely numbers 1, 0 and letters l, O
- use always parentheses ( )
- explain abbreviations always when first used


MANUSCRIPT REQUIREMENTS

1. An accurate paper title, names and surnames of all authors including titles, authors` workplace. The first author address including the phone number, fax and e-mail address.
2. Summary - structured abstract: goal of work, material and methods (do not state the name of the workplace), results, conclusion
3. Key words - in the extent of 3-6.
Write in 1st or 3rd person singular or plural (unify according the type of an article).
4. English translation: the title of the paper, summary, key words 5. Text
If you insert pictures into a document, send also their original files in "jpg" format, create graphs in Excel and send also their original files. If you send photo documentation via post office, please, send just high-class originals. Mark each original by a number, under which it is mentioned in the text. Write in 1st or 3rd person singular or plural (unify according the type of an article). In the text do not use highlighting of the text as e.g. underlined text, bold, with exception of titles, references to pictures, tables, graphs.

6. Bibliography
Citations are numbered chronologically in bold, references in the text are stated by the number of citations in parentheses.
Citation means in general: the surname of the author (authors), title of the work, year of issuing, volume, pages.
Do not use "ét al.", but state all authors.

Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett´ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981:15-27.

Do not use dots after first names in citations. Do not use colon but dot after names of authors. Use semi-colon after the year of publishing, colon is before pages.

The editorial board reserves the right to make small stylistic changes in the paper. If it is necessary to shorten the paper, the consent of the author will be required. All articles are reviewed.

Which of following factors is not related to rosacea?
a. genetic predisposition
b. Scandinavian origin
c. propionibacterium acnes
d. endothelial growth factor

The editorial board reserves the right to make small stylistic changes in the paper. If it is necessary to shorten the paper, the consent of the author will be required. All articles are reviewed.

All published papers are paid.

Send contributions in the e-mail to the address: paulenova@amedi.sk