Startseite Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
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Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures

  • Saman Anwar Wahid , Shakhawan Hama Amin Said EMAIL logo , Lusan Abdulhameed Arkawazi , Mzhda Sahib Jaafar , Zhino Nuri Hussein und Attar Abdul Kareem Nadir
Veröffentlicht/Copyright: 6. September 2025
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Open Medicine
Aus der Zeitschrift Open Medicine Band 20 Heft 1

Abstract

Background

Laparoscopic adrenalectomy (LA) is the gold standard technique for well-selected patients with an adrenal mass. The surgical team’s experience is an essential factor in the surgical outcome.

Objective

The aim of this study was to assess the outcomes of patients who underwent lateral transperitoneal LA to remove their adrenal mass.

Methods

In this case-series study, 20 consecutive patients with adrenal mass were enrolled in Sulaimani Teaching Hospital, Sulaimaniyah, Iraq, from March 2019 to March 2022. Patients underwent lateral transperitoneal LA under general anaesthesia. Then, the type of LA, operation time, mass size, hospital stay, histopathological finding, and postoperative complications were assessed.

Results

Most patients were females (65%), underwent left-sided LA (55%), had a nonfunctioning mass (55%), and had no postoperative complications (85%). The mean operation time was 95 ± 2.0 min, and the mean hospital stay was 3.2 ± 1.5 days. Most patients were detected incidentally through radiology (55%), while others were detected after biochemical tests were done, including cases of pheochromocytoma (25%), hypercortisolism (10%), and hyperaldosteronism (10%). Most patients had benign cortical adenoma (45%), followed by benign medullary pheochromocytoma (25%), myelolipoma (15%), oncocytoma, adrenal hyperplasia, and ganglioneuroma (5.0% each).

Conclusions

LA seems to be a safe and feasible option for selected cases in this locality.

Keywords: laparoscopic technique; lateral transperitoneal adrenalectomy; functioning adrenal tumours; nonfunctioning adrenal mass

1 Introduction

Adrenal tumours are very commonly encountered in the practice of radiology. They may arise from the adrenal gland (the cortex or the medulla) or be secondary lesions. They may be benign or malignant. Clinically unapparent adrenal tumours (≥1 cm in diameter) are found in 2–10% of the population worldwide, known as adrenal incidentaloma, which is commonly discovered incidentally on cross-sectional abdominal imaging performed for reasons other than adrenal mass [1]. The incidence of adrenal tumours increased 10-fold in the past two decades, with most diagnosed in older adults. Malignancy is diagnosed in 5–8% of patients with adrenal tumours, with a higher risk in young patients [2].

Functioning adrenal tumours lead to hypersecretion of adrenal hormones (mainly cortisol and aldosterone) and result in clinical syndromes. In contrast, nonfunctioning (inactive) adrenal adenomas do not produce excess adrenal hormones and comprise most adrenal adenomas. The latter do not cause symptoms or require treatment [3,4]. Computed tomography (CT) and positron emission tomography are the most common imaging modalities for the initial evaluation of adrenal tumours. Magnetic resonance imaging (MRI) and functional scintigraphic techniques are frequently used for atypical presentations or further assessment. Additionally, molecular tests such as F-18 FDG, I-123 metaiodobenzylguanidine, and In-111 Octreotide imaging are essential in the diagnostic algorithm of the adrenal masses [5].

Laparoscopic adrenalectomy (LA) was first described through a transperitoneal approach by Gangar in 1992 as a surgical treatment for most adrenal tumours. Since then, LA has been regarded as a gold standard technique for small benign lesions and adrenal masses [6]. Malignant adrenocortical tumours are the leading cause of open surgery to avoid the dissemination of cancer. Tumour size is essential for decision-making, but no consensus exists for open surgery indication. However, open adrenalectomy (either via a large flank or abdominal incision) is associated with high morbidity, especially in obese patients. At the same time, LA appears to achieve superior results regarding recovery, cosmetics, and morbidity [7].

Moreover, LA has shorter operative time, less postoperative pain, less need for analgesia, early hospital discharge, and return to daily activity [7,8]. Most surgeons prefer the transperitoneal approach due to the ample and familiar working space and clear anatomic landmarks. Still, it carries more risk of visceral injury and postoperative pain than the retroperitoneal approach [9]. Thus, we used lateral transperitoneal LA to remove the adrenal mass and studied its postoperative outcomes among patients.

2 Materials and methods

2.1 Study design and setting

The case-series prospective study was performed on 20 consecutive patients with an adrenal mass in Sulaimani Teaching Hospital, Sulaimaniyah, Kurdistan region, Iraq, from March 2019 to March 2022.

2.2 Inclusion criteria

Patients with functioning and nonfunctioning adrenal mass (<100 mm diameter) and without features of malignancy were included, regardless of age and gender.

2.3 Exclusion criteria

Patients with other malignancies rather than adrenal mass and those with multiple endocrine neoplasia type 2 (MEN 2a) and subclinical Cushing syndrome were excluded.

2.4 Diagnosis

All adrenal masses were radiologically assessed by abdominal ultrasonography, CT, and MRI when required for further identification of the radiologic features of the tumours. Patients’ sociodemographic data were collected, including age, gender, and body mass index (BMI, kg/m2). Then, 5.0 mL of venous blood was collected from each patient for biochemical tests. Plasma-free cortisol was done to exclude subclinical Cushing syndrome. Patients with features of hypercortisolism were further assessed by measuring 24 h urinary free cortisol, dexamethasone suppression test, and plasma adrenocorticotropic hormone level when indicated. Whereas patients presented with hypertension were investigated for plasma metanephrines, renin, aldosterone, and renin/aldosterone ratio subsequently. Patients with suspected pheochromocytoma were additionally examined for parathyroid hormone, and serum calcium was used to exclude MEN 2a.

2.5 Preoperative preparation

Preoperative medications were tailored to patient’s needs and tumour functionality. Patients with Cushing syndrome were given appropriate antihypertensive medication, and all were shifted to the appropriate insulin subtype injection the day before the operation. For pheochromocytoma cases, blood pressure was controlled over 2 weeks with increasing doses of Doxazosin tablets, followed by adding propranolol for another 2 weeks to control reflex tachycardia. In cases of Cohn’s syndrome, the blood pressure was controlled using an appropriate dose of spironolactone, and one of our cases presented with severe hypokalaemia (2.2 mEq/L) that required intravenous infusion of potassium over 48 h preoperatively, and another 80 mEq was given on the first postoperative day. All patients had routine haematologic, virology investigations, medical, and cardiologic assessment.

2.6 Surgical procedure

All patients received general anaesthesia, prophylactic antibiotics, and a central venous cannula and an arterial access cannula were established intraoperatively. All patients received one dose of hydrocortisone (100 mg, intravenously), which was repeated every 8 h if needed, and they were placed in the corresponding lateral decubitus position; the operation table was bent 40–60° at the level of the flank. We did not report any intra-operative hemodynamic instability; thus, no case has received any vasoactive medication intra-operatively. Consequently, 21 LA were done for 20 consecutive patients; then they were followed up for different durations based on the severity of the cases. Finally, the type of LA (left, right, and bilateral), operation time (minutes), mass size (mm), hospital stay (days), histopathological findings, and postoperative outcomes were assessed among operated patients. Then, they were followed up for at least 1 year, at 3-month intervals.

2.7 Statistical analysis

The statistical analysis was conducted using the IBM Statistical Package for the Social Sciences (SPSS, Chicago, USA, version 25). The data were presented in frequency and percentages with mean ± standard deviation (SD).

  1. Ethical approval: All procedures, including patient selection and data collection, were approved by the Ethical Committee of the College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq (No. 20/2 on January 20, 2019). The Declaration of Helsinki was followed throughout all study phases to ensure the highest level of ethical conduct.

  2. Informed consent: Before the surgery, the patients provided written informed consent, and the surgical procedure and perioperative outcomes were discussed with them.

3 Results

The patients’ mean age was 39.9 ± 2.1 years, ranging from 23 to 56 years. Seven (35%) were males, and 13 (65%) were females. The mean BMI was 29.5 ± 1.1 kg/m2. Most patients underwent left-sided LA (n = 11, 55%), followed by proper LA (n = 8, 40%), and only one case (5.0%) underwent bilateral adrenalectomy. The mean operation time was 95 ± 2.0 min, ranging from 45 to 160 min, and the mean hospital stay was 3.2 ± 1.5 days (ranging from 2 to 9 days) (Table 1). Only one patient stayed 9 days post-operatively and was admitted to the intensive care unit (ICU) and re-operated, as she developed severe abdominal pain and abdominal distension and was hemodynamically unstable on the first postoperative day. During a review of her recorded LA video, a small amount of greenish fluid (bile) in the operated area was noticed (Figure 1), which was unrecognized by the surgical team. Thus, she was diagnosed with bowel injury. The patient was explored on the second postoperative day, and suturing was done to remove 0.5 cm of tear in the posteromedial surface of the second part of the duodenum.

Table 1

Sociodemographic and tumour characteristics of the patients

Case Age (years) Gender Laterality BMI Diameter (mm) Presentation Biochemical result Histopathology Follow-up (months)
1 29 F L 29 30 Incidentaloma N BCA 36
2 23 F R 23 40 Incidentaloma N ML 33
3 56 F R 33 42 Incidentaloma N ML 31
4 27 F L 24 78 Incidentaloma N Benign oncocytoma 29
5 54 F R&L 42 L70/R 68 Cushing disease Hypercortisolism Adrenal hyperplasia 27
6 56 M L 40 48 Incidentaloma N BCA 27
7 54 F L 39 45 Incidentaloma N BCA 24
8 27 F R 32 75 Hypertension Pheochromocytoma BMPh 22
9 36 M R 27 27 Conn’s syndrome Hyperaldosteronism BCA 20
10 44 F L 32 50 Hypertension Pheochromocytoma BMPh 19
11 53 F R 28 35 Hypertension Pheochromocytoma BMPh 17
12 28 F L 23 56 Incidentaloma N GN 15
13 48 M R 36 54 Hypertension Pheochromocytoma BMPh 12
14 36 F L 33 44 Incidentaloma N BCA 12
15 28 F L 22 54 Cohn’s syndrome Hyperaldosteronism BCA 10
16 39 M R 23 42 Incidentaloma N BCA 7
17 34 M L 21 53 Incidentaloma N ML 6
18 44 F L 33 65 Cushing syndrome Hypercortisolism BCA 5
19 38 M L 28 48 Hypertension Pheochromocytoma BMPh 3
20 43 M R 23 58 Incidentaloma N BCA 3

M: male, F: female, N: negative, BMI: body mass index, BCA: benign cortical adenoma, ML: myelolipoma, BMPh: benign medullary pheochromocytoma, GN: ganglioneuroma.

Figure 1 Intraoperative bile leak (arrows) is seen medial to the inferior vena cava, the adrenal gland (A), and below the caudate lobe of the liver (L).
Figure 1

Intraoperative bile leak (arrows) is seen medial to the inferior vena cava, the adrenal gland (A), and below the caudate lobe of the liver (L).

Moreover, the maximum mass size was 7.8 cm (a case of benign oncocytoma) for nonfunctioning masses and 7.5 cm for functioning masses (a case of pheochromocytoma). Most adrenal masses were non-functioning (n = 11, 55%, incidentaloma; incidentally detected through radiology), while the rest were functioning (45%). Among functioning cases, five patients had pheochromocytoma (25% presented with hypertension), followed by hypercortisolism (n = 2, 10%, Cushing disease) and hyperaldosteronism (n = 2, 10%, Conn’s syndrome). Furthermore, histopathological examination revealed that most patients (n = 9, 45%) had benign cortical adenoma (BCA), followed by benign medullary pheochromocytoma (n = 5, 25%), then myelolipoma (n = 3, 15%). In contrast, only one case from each benign oncocytoma, adrenal hyperplasia, and ganglioneuroma was reported (5.0% each) (Table 1). Based on the Clavien–Dindo classification to rank the severity of a surgical complication, two patients had Dindo 1–2 (10%) and only one patient had Dindo 3–4 (5.0%). In contrast, no one had Dindo 5 and without any mortality among operated patients (Table 2).

Table 2

Clinical outcomes in our case series

Intraoperative data Number of cases
ICU admission 1*
Complication
Dindo 1–2 2**
Dindo 3–4 1*
Dindo 5 0
Re-operation 1*
Mortality 0

*Duodenal injury requiring ICU admission and reoperation. **Transient ileus.

4 Discussion

Choosing from the available surgical strategies to manage adrenal masses is a big challenge. Thus, we planned to share our initial experience with the LA performed by the same urologic team for the first time at Sulaimani Teaching Hospital, Sulaimaniyah, Kurdistan Region, Iraq, for patients with an adrenal mass. Finally, our results were compared to the literature (Table 3). In this study, most patients were overweight, young adults, and females, with a mean mass size of 50.65 mm, and were detected incidentally (not due to excess hormonal secretion). These results somewhat agreed with those of Iñiguez-Ariza et al., who found that older age, male sex, non-incidental mode of discovery, larger mass size, and higher unenhanced CT attenuation were associated with an increased risk for malignancy [10].

Table 3

Comparative clinical outcome between our case series and some other studies

Study No. of cases Mean operative time (min) Mean hospitalization (days) Conversion Clavien-Dindo 3 and 4 Mortality
Köstek et al. [6] 76 N/A 7.1 4 (5.3%) 9 (11.8%) 1 (1.3%)
Öz et al. [7] 100 101 3.4 8 (8%) 9 (9%) 0
Simforoosh et al. [13] 65 149 N/A 5 (7.5%) 4 (5.8%) 0
Naya et al. [18] 28 202 9 4 0 0
Our case series 20 95 3.2 0 1 (5%) 0

Moreover, in the present study, most patients had a left-side mass (55%), followed by a right-side mass (40%), and only one case (5.0%) had a bilateral mass that experienced bilateral adrenalectomy. These results align with Iñiguez-Ariza et al., who found that 43% of patients had left-side mass, 42% had right-side mass, and 15% had bilateral mass [10]. Also, we found the mean operation time of 95 ± 2.0 min (ranging from 45 to 160 min) and the mean hospital stay of 3.2 ± 1.5 days (ranging from 2 to 9 days). This team’s operation time and hospital stay were less than those reported by Di Buono et al., who found the mean operative time of 145 min (ranging from 75 to 240 min) and mean length of hospital stay of 3.7 days (ranging from 3 to 6 days) [11]. Additionally, the maximum mass size in the current study was 7.8 cm (benign oncocytoma, fourth case) for a nonfunctioning mass and 7.5 cm for a functioning mass (pheochromocytoma, eighth case). However, other studies consider a maximum mass diameter of 12 cm for LA [12,13], while others suggest LA for mass sizes up to 15 cm [14,15].

Some studies suggest open surgery for adrenal masses that are highly suspected of malignancy, recurrence, having lymphadenopathy, or vascular thrombosis [14]. Sommerey et al. published 10 years of experience in LA and suggested a traditional approach to complete resection and lymphadenectomy to achieve a long-term cure [16]. Nevertheless, Brix et al. performed both open and LA for 152 patients and found a comparable frequency of mass laceration and peritoneal contamination in both groups, with better quality of life in patients who underwent LA [17,18].

We reported no incidence of intraoperative prolonged hemodynamic instability, no intraoperative blood transfusion, no conversion to open, and no mortality. One case (5.0%) had a severe complication and reoperation. She was admitted to the ICU and re-operated on by laparotomy for bowel injury on the second postoperative day. These results are much better and superior to some other studies, such as that of Simforoosh et al., who operated 65 cases through the transperitoneal approach, and they had a 7.5% conversion rate (5 cases) and a 5.8% complication rate (4 cases) [13]. Köstek et al. reported 9 cases (11.8%) with complications in their series of 76 adrenalectomies: bleeding from the spleen (2 cases), bleeding from liver parenchyma (2 cases), one case of bleeding from the upper pole of the kidney, and one renal artery injury [6]. Öz et al. reported a 9.0% complication rate among 100 cases, of which eight patients suffered intraoperative bleeding that converted to open surgery, and one case had a diaphragmatic rupture [7].

5 Conclusions

LA is a safe, adorable, and effective option for selected cases in our locality. Our surgical team’s outcome is comparable to other series in the literature in terms of a short operative time, low blood loss, no conversion to open surgery, and a short hospital stay.

Acknowledgments

The authors would like to thank the healthcare staff at the hospital in Sulaimaniyah, Iraq, for their help and support in this study.

  1. Funding information: The authors state that no funding information.

  2. Author contributions: SAW: conceptualization, methodology, data collection, and writing the original manuscript; SHAS: supervision, study registration, methodology, editing the final draft; LAA: methodology and writing the original manuscript; MSJ: methodology, data collection, and writing the original manuscript; ZNH: methodology, data collection, and writing the original manuscript. AAKN: study administration, resources, data analysis, and original manuscript writing. All authors have agreed to submit the manuscript to this journal.

  3. Conflict of interest: The authors state that no conflict of interest.

  4. Data availability statement: The original data of this study are available with the corresponding author and can be provided upon request.

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Received: 2025-01-06
Revised: 2025-05-10
Accepted: 2025-05-29
Published Online: 2025-09-06

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Review Articles
  128. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  129. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  130. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  131. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  132. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  133. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  134. The application of augmented reality in robotic general surgery: A mini-review
  135. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  136. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  137. Plant polyphenols, terpenes, and terpenoids in oral health
  138. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  139. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  140. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  141. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  142. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  143. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  144. Giant borderline ovarian tumours – review of the literature
  145. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  146. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  147. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  148. Supplement strategies for infertility in overweight women: Evidence and legal insights
  149. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  150. Case Reports
  151. Delayed graft function after renal transplantation
  152. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  153. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  154. Giant right atrial hemangioma presenting with ascites: A case report
  155. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  156. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  157. Rapid Communication
  158. Biological properties of valve materials using RGD and EC
  159. Letter to the Editor
  160. Role of enhanced external counterpulsation in long COVID
  161. Expression of Concern
  162. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  163. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  164. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  165. Corrigendum
  166. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  167. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  168. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  169. Retraction
  170. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  171. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  172. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  173. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  174. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  175. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  176. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  177. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  178. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  179. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  180. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  181. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  182. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  183. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  184. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  185. Special Issue Diabetes
  186. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  187. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  188. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  189. A review of brain research on T2DM-related cognitive dysfunction
  190. Special Issue Biomarker Discovery and Precision Medicine
  191. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1230
Schlagwörter für diesen Artikel
laparoscopic technique; lateral transperitoneal adrenalectomy; functioning adrenal tumours; nonfunctioning adrenal mass
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Review Articles
  128. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  129. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  130. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  131. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  132. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  133. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  134. The application of augmented reality in robotic general surgery: A mini-review
  135. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  136. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  137. Plant polyphenols, terpenes, and terpenoids in oral health
  138. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  139. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  140. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  141. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  142. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  143. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  144. Giant borderline ovarian tumours – review of the literature
  145. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  146. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  147. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  148. Supplement strategies for infertility in overweight women: Evidence and legal insights
  149. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  150. Case Reports
  151. Delayed graft function after renal transplantation
  152. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  153. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  154. Giant right atrial hemangioma presenting with ascites: A case report
  155. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  156. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  157. Rapid Communication
  158. Biological properties of valve materials using RGD and EC
  159. Letter to the Editor
  160. Role of enhanced external counterpulsation in long COVID
  161. Expression of Concern
  162. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  163. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  164. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  165. Corrigendum
  166. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  167. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  168. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  169. Retraction
  170. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  171. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  172. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  173. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  174. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  175. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  176. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  177. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  178. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  179. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  180. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  181. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  182. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  183. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  184. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  185. Special Issue Diabetes
  186. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  187. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  188. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  189. A review of brain research on T2DM-related cognitive dysfunction
  190. Special Issue Biomarker Discovery and Precision Medicine
  191. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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Heruntergeladen am 2.10.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2025-1230/html?lang=de
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