Biomedical subjects

P N Romashchenko

Publications and source records attributed to P N Romashchenko.

3 recordsLinked to original sources

PubMed2005

[The diagnosis and treatment of chromaffinomas].

The results of examinations and surgical treatment of 117 patients with chromaffin tumors are shown: one-sided localization in the adrenal in 88% of the patients, bilateral localization in 4.3%, and extraadrenal in 7.7%. An analysis of the possibilities of the laboratory-instrumental diagnosis of chromaffinomas has shown that the method should be used in case of valid need. The absence of changes to the level of catecholamines and their metabolites in urine does not exclude the presence of chromaffinomas. The optimal access for the ablation of chromaffinoma of the adrenal larger than 5 cm in diameter is thoracofrenotomy in the tenth intercostal space. Endovideosurgical interventions in the adrenals can be used for the size of chromaffinoma less than 5 cm in diameter and with the absence of signs of malignisation and marked hemodynamic disorders. The superior medial laparotomy is expedient for extraadrenal pheochromocytoma of the abdominal area and for bilateral localization in the adrenals.

Adrenal Gland Neoplasms↗

PubMed2004

["Silent" pheochromocytomas].

The results of surgical treatment of 126 patients with "hormonally inactive" and catecholamine secreting tumors of the adrenals were studied. Among them 2 cases (1.6%) of "dumb" pheochromocytoma were diagnosed. The clinical observations have shown the difficulties in the diagnosis of "dumb" pheochromocytoma before operation, risk of performing adrenalectomy and necessity to correct hemodynamic disorders during anesthesia in connection with latent catecholamine activity. The laboratory and instrumental means of examination of patients with suspected "hormonally inactive" tumor of the medullary substance of the adrenal are proposed. The variants of prevention and arrest of hemodynamic disorders during ablation of the "dumb" pheochromocytoma were considered. When the "dumb" pheochromocytoma had the diameter less than 5 cm and the adequate preparation was conducted the authors propose a laparoscopic access for adrenalectomy on the right, and retroperitoneoscopic access on the left. The detection of the catecholamine secreting tumor of more than 5 cm diameter, when problems with the clipping of the central vein of the adrenal take place, open accesses should be preferred--mainly thoracophrenotomy in the X intercostal space. If it was not possible to prove "dumb" pheochromocytoma before operation and it was started with endovideosurgical intervention during which it was not possible to first clip the central vein of the adrenal and the risk of hemodynamic disorders was high, the early transition to open operative intervention is thought to be expedient.

Adrenal Gland Neoplasms↗

PubMed2002

[Clinico-anatomic rationale for the access and technique in video-endoscopic adrenalectomy].

The results of surgical treatment of 60 patients with tumors of the adrenals with the help of endovideosurgical techniques were analyzed and described. The article also presents the data of experimental investigations performed in 31 corpses of subjects of different constitution and topography of the adrenals in the retroperitoneal space and different accesses to them with the help of endovideosurgical technique. The most effective and safe accesses and the method of endovideosurgical adrenalectomy have been developed, substantiated and approbated in clinical practical work. In most cases the right laparoscopic and left retroperitoneoscopic adrenalectomies should be considered the operations of choice in treatment of patients with tumors of the adrenals. It was proved that the decision for the optimal endovideosurgical access and the corresponding adrenalectomy should be made individually for each patient with special reference to the clinicoanatomical criteria found. The endovideosurgical adrenalectomy should not be opposed to open methods of surgery which are expedient in patients with large size of the tumor, signs of malignancy and possible intraoperative complications.

Adrenal Gland Neoplasms↗