ABSTRACT
Laparoscopic resection of the adrenal tumor was carried out in 8 patients since January 1993. The age of the patients was 22 to 45 years, 6 with aldosteronism and 2 with Cushing's syndrome. The tumors were located in righ adrenal in 5 cases and left adrenal in 3. The tumor size was 1.0-3.6 cm. All laparoscopic procedures were performed under general edothacheal anesthesia. The operative time ranged from 90 minutes to 4 hours. Bleeding volume during the operation was 20-90 ml. We developed a reliable technique for adrenal tumor using a laparoscopic approach. The anatomy of adrenal glands, operative indications and complications are discussed. Laparoscopic resection of the adrenal tecmos is a valuable method.
Subject(s)
Adrenal Gland Neoplasms/surgery , Laparoscopy/methods , Adrenal Gland Neoplasms/complications , Adult , Cushing Syndrome/etiology , Female , Humans , Hyperaldosteronism/etiology , Male , Middle AgedABSTRACT
In addition to vasoconstriction, endothelin (ET) has been reported to show various endocrine actions in animals. However, no data have emerged concerning the effect of ET on adrenal function in humans. We, therefore, investigated the effects of ET on aldosterone and cortisol secretion from adrenocortical tissues obtained from normal subjects (n = 6) and patients with primary aldosteronism (n = 5). Adrenal tissue slices were incubated at 37 C for 120 min in modified Krebs-Ringer solution containing glucose and HEPES. ET increased aldosterone secretion from normal adrenocortical tissue in a dose-dependent manner, with an ED50 of 0.036 nmol/L, although the maximum response was small compared with that to angiotensin-II. ET also stimulated aldosterone secretion from tissues adjacent to the adenoma, but not from the adenoma, in patients with primary aldosteronism. The effects of ET on aldosterone secretion were significantly suppressed by calcium channel blockade with nicardipine. ET did not affect cortisol secretion from the adrenal tissues. These results suggest that ET is one of the factors that regulates aldosterone secretion in humans.
