Role and Operative Risk of Bilateral Adrenalectomy in Hypercortisolism View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1996-07

AUTHORS

Yves Chapuis, Jol Pitre, Filomena Conti, Bassam Abboud, Nicole Pras-Jude, Jean-Pierre Luton

ABSTRACT

Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 patients operated on during the last 15 years. The causes of hypercortisolism were Cushing's disease (n = 78), ectopic ACTH syndrome (n = 3), and primary adrenocortical nodular dysplasia (Carney-Meador syndrome) (n = 1). Before operation 37% of the patients had severe symptoms of hypercortisolism. A bilateral posterior approach was undertaken in 58 patients, whereas 18 patients had an anterior transabdominal approach and 6 patients a laparoscopic approach. There were two operative deaths (2.4%). Postoperative complications occurred mostly in cases of advanced disease and were observed in 14 patients (17%), among whom 4 had severe complications. At long-term follow-up, one recurrence of hypercortisolism and 12 Nelson syndromes (15%) were observed. In conclusion, bilateral adrenalectomy carries an acceptable operative risk, and we recommend bilateral adrenalectomy rather than long-term suppressive therapy in patients requiring prompt and definitive control of their hypercortisolism or after pituitary surgery failure. More... »

PAGES

775-780

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s002689900118

DOI

http://dx.doi.org/10.1007/s002689900118

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026872979

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/8678950


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