The Use of Three-dimensional Printers for Partial Adrenalectomy: Estimating the Resection Limits

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art_SROUGI_The_Use_of_Threedimensional_Printers_for_Partial_Adrenalectomy_Es_2016.PDF (836.85 KB)
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27
Tipo de produção
article
Data de publicação
2016
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Scopus
Web of Science
PubMed
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ELSEVIER SCIENCE INC
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Citação
UROLOGY, v.90, p.217-220, 2016
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Unidades Organizacionais
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OBJECTIVE To avoid hormonal replacement after partial adrenalectomy (PA), establishing the precise limit of an adrenal gland resection is essential. Herein, we evaluated the use of three-dimensional (3D) adrenal gland printing and volumetry measurement before PA to improve the determination of the remnant gland volume. METHODS Concomitant total adrenalectomy and a contralateral PA were performed in a patient with primary macronodular adrenal hyperplasia that exhibited mild hypercortisolism, arterial hypertension, and diabetes. Before surgery, a 3D replica of the adrenal gland to be partially resected was printed and given to the surgeon. The volumetry of the gland was measured by computed tomography 3D image reconstruction. RESULTS No postoperative complications were noted. Immediately after the surgery, the patient initiated corticosteroid replacement, which was interrupted 52 days later. At the 6-month follow-up, the patient stopped using medications for diabetes and reduced the number of antihypertensive medications from 5 to 1. The pre- and postoperative serum cortisol levels were, respectively, 28 and 8.7 mcg/dl (n 5-25 mcg/dl). The pre-and postoperative adrenocorticotropic hormone levels were, respectively, <5 and 88 pg/ml (n 7.2-63 pg/ml). The postoperative adrenal volume was 12% of the total preoperative adrenal volume. CONCLUSION The use of 3D printing associated with adrenal volumetry might be a useful tool for the surgeon when performing PA, enabling an estimation of the remnant gland volume. (C) 2016 Elsevier Inc.
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https://observatorio.fm.usp.br/handle/OPI/14129
Referências
  1. Akiba T, 2014, ANN THORAC CARDIOVAS, V20, P490, DOI 10.5761/atcs.cr.13-00238
  2. Brauckhoff M, 2003, SURGERY, V134, P1020, DOI 10.1067/S0039-6060(03)00503-8
  3. Pautler SE, 2002, J UROLOGY, V168, P1352, DOI 10.1097/01.ju.0000031272.56889.28
  4. Schmauss D, 2014, ANN THORAC SURG, V97, P2160, DOI 10.1016/j.athoracsur.2014.02.011
  5. Diner EK, 2005, UROLOGY, V66, P19, DOI 10.1016/j.urology.2005.01.009
  6. Silberstein JL, 2014, UROLOGY, V84, P268, DOI 10.1016/j.urology.2014.03.042
  7. Asari R, 2006, ARCH SURG-CHICAGO, V141, P1199, DOI 10.1001/archsurg.141.12.1199
  8. Brauckhoff M, 2008, WORLD J SURG, V32, P863, DOI 10.1007/s00268-007-9402-y
  9. Gupta GN, 2014, J ENDOUROL, V28, P112, DOI 10.1089/end.2013.0298
  10. Walz MK, 1997, ZBL CHIR, V122, P481
  11. De Venanzi A, 2014, CURR OPIN ENDOCRINOL, V21, P177, DOI 10.1097/MED.0000000000000061
  12. Fragoso MCBV, 2015, J ENDOCRINOL, V224, pR31, DOI 10.1530/JOE-14-0568
  13. Kaye DR, 2010, J UROLOGY, V184, P8
  14. Mehra Pushkar, 2011, J Maxillofac Oral Surg, V10, P6, DOI 10.1007/s12663-011-0183-3
  15. Nagaraja V, 2015, INT J SURG, V16, P7, DOI 10.1016/j.ijsu.2015.01.015
  16. Starosolski ZA, 2014, PEDIATR RADIOL, V44, P216, DOI 10.1007/s00247-013-2788-9

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/42
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