Importance of the Adrenal Gland Blood Supply During Laparoscopic Subtotal Adrenalectomy

2010 ◽  
Vol 20 (4) ◽  
pp. 311-315 ◽  
Author(s):  
Craig N. Parnaby ◽  
Norman Galbraith ◽  
Patrick J. O'Dwyer
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ran Xu ◽  
Ziling Zhu ◽  
Wenjuan Tang ◽  
Qichang Zhou ◽  
Shi Zeng

Abstract Background The fetal adrenal gland is a highly vascularized organs and develops two recognizable distinct zones in uetro, inner fetal zone (FZ) and outer definitive zone (DZ). Based on the region supplied, middle adrenal artery (MAA) mainly contribute to FZ while inferior adrenal artery (IAA) mainly to the inferior part of DZ. The purpose of this study was to establish reference ranges of adrenal artery Doppler indices of IAA and MAA, and assess zonal difference of blood supply to fetal adrenal gland. Methods The pulsatility index (PI), resistance index (RI), and systolic:diastolic ratio (S/D) of the IAA and MAA were obtained serially at 4-week intervals in normal fetuses. The MAA and IAA were referred based on the course and location in the gland: IAA referring the artery that mainly branches from the renal artery and walks along the renal upper pole, distributing the inferoposterior part of DZ in the adrenal gland while MAA as arterial blood flowing along the single central adrenal vein in the medial part of the gland. Multilevel modeling was performed to establish the gestational age-associated reference ranges for IAA and MAA. Differences in Doppler indices between the IAA and MAA were assessed. Results One hundred sixty-eight fetuses with 843 observations were included. The IAA had a higher detection rate than the MAA (100% vs 89.2%, p < 0.05). The resistance of IAA had a reduction around 35 weeks of gestation and that of MAA remained unchanged throughout the second half of pregnancy. Lower PI, RI and S/D were observed in the MAA than in the IAA (p < 0.05) from 752 paired measurements. Conclusion There is a zonal difference in blood supply in favor of the fetal zone, which may correspond to its unique function. Reference ranges of Doppler parameters in adrenal artery maybe beneficial for further evaluation of fetal hemodynamics.


2008 ◽  
Vol 31 (6) ◽  
pp. 471-473 ◽  
Author(s):  
Johann Peltier ◽  
Xavier Demondion ◽  
Marc Baroncini ◽  
Guillaume Wavreille ◽  
Christian Fontaine ◽  
...  

2020 ◽  
Vol 73 (9) ◽  
pp. 1977-1981
Author(s):  
Sergiy P. Styopushkin ◽  
Viktor P. Chaikovskyi ◽  
Volodymyr A. Chernylovskyi ◽  
Ruslan V. Sokolenkо

The aim: To optimize the indications for partial laparoscopic adrenalectomy (PLA), to give a detailed outline of a PLA technique and to provide technical tips to ensure safe and highly-effectiveness, based on the knowledge of adrenal anatomy and blood supply. Materials and methods: Between January 2010 and September 2018, our department performed 47 adrenal glands surgeries. The operations included 29 total laparoscopic adrenalectomies (TLA), 4 open adrenalectomies (OA) and 14 partial laparoscopic adrenalectomies (PLA). Results: The histopathological examination of all operated patients detected 9 (19.1%) malignant tumors, including 5 metastatic tumors. Benign tumors includes 24 (63%) adenomas, 8 (21%) pheochromocytomas, 4 (10,5%) cysts and 2 (5,5%) ganglioneuromas. Post-PLA histopathological findings revealed 6 adenomas, 2 pheochromocytomas, 4 cysts and 2 ganglioneuromas. Conclusions: Keeping in mind anatomical features of adrenal gland blood supply in highly-selected patients, PLA can be performed in a number of patients. 2 mm of a minimal resection margin is enough to preserve a false tumor recurrence. Anatomically grounded PLA is becoming a new standard of benign adrenal gland tumors treatment, providing an opportunity to save more adrenal gland functional tissue and to prevent hipocorticism development in postoperative period.


Author(s):  
T. M. Murad ◽  
Karen Israel ◽  
Jack C. Geer

Adrenal steroids are normally synthesized from acetyl coenzyme A via cholesterol. Cholesterol is also shown to enter the adrenal gland and to be localized in the lipid droplets of the adrenal cortical cells. Both pregnenolone and progesterone act as intermediates in the conversion of cholesterol into steroid hormones. During pregnancy an increased level of plasma cholesterol is known to be associated with an increase of the adrenal corticoid and progesterone. The present study is designed to demonstrate whether the adrenal cortical cells show any dynamic changes during pregnancy.


Author(s):  
John L. Beggs ◽  
Peter C. Johnson ◽  
Astrid G. Olafsen ◽  
C. Jane Watkins

The blood supply (vasa nervorum) to peripheral nerves is composed of an interconnected dual circulation. The endoneurium of nerve fascicles is maintained by the intrinsic circulation which is composed of microvessels primarily of capillary caliber. Transperineurial arterioles link the intrinsic circulation with the extrinsic arterial supply located in the epineurium. Blood flow in the vasa nervorum is neurogenically influenced (1,2). Although a recent hypothesis proposes that endoneurial blood flow is controlled by the action of autonomic nerve fibers associated with epineurial arterioles (2), our recent studies (3) show that in addition to epineurial arterioles other segments of the vasa nervorum are also innervated. In this study, we examine blood vessels of the endoneurium for possible innervation.


Author(s):  
W.T. Gunning ◽  
G.D. Haselhuhn ◽  
E.R. Phillips ◽  
S.H. Selman

Within the last few years, adrenal cortical tumors with features concordant with the diagnostic criteria attributed to oncocytomas have been reported. To date, only nine reported cases exist in the literature. This report is the tenth case presentation of a presumptively benign neoplasm of the adrenal gland with a rare differentiation. Oncocytomas are well recognized benign tumors of the thyroid, parathyroid, and salivary glands and of the kidney. Other organs also give rise to these types of tumors, however with less frequency than the former sites. The characteristics generally used to classify a tumor as an oncocytoma include the following criteria: the tumor is 1) usually a solitary circumscribed mass with no gross nor microscopic evidence of metastasis (no tissue nor vascular invasion), 2) fairly bland in terms of mitotic activity and nuclear morphology, and 3) composed of large eosinophillic cells in which the cytoplasm is packed full of mitochondria (Figure 1).


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