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>Journals >Cirujano General >Year 2002, Issue 3


Soliva DR, Savío LAM, Copo JJA, Recio PH, Martínez CO
Results of adrenal surgery for the treatment of hypercortisolism
Cir Gen 2002; 24 (3)

Language: Español
References: 36
Page: 184-190
PDF: 4. Kb.


Full text




ABSTRACT

Objective: To assess the results of adrenalectomies in patients with hypercortisolism.
Setting: Third level health care hospital.
Design: Retrospective, observational study.
Statistical analysis: Median, percentage, and Pearson’s correlation.
Results: Forty-five adrenalectomies were performed in 33 patients, two of them were men, average age of 33.4 years. Cortico-suprarrenal hyperplasia was the most frequent form of the syndrome (60%). Twenty patients presented antecedents of hypohypophysiary adenoma, in seven it had been resected previously by trans-sphenoidal approach. In 51.1% (23), the adrenalectomies were left-sided and in 48.9% (22) right-sided; in 35 (77.8%) the approach was lumbar and in 10 (22.2%) laparoscopic. Average surgical time was of 106 minutes. There were 17 transoperative accidents (37.8%), the most frequent one was pleural opening (17.8%). In the long-term, 6 (18.18%) patients presented Nelson syndrome. One post-operative death (2.2%) occurred due to congestive cardiac failure. Average hospital stay was of 6 days.
Conclusion:
Adrenalectomy is a safe and efficient procedure for the treatment of hypercortisolism. The laparoscopic approach to the suprarenal gland is safe and effective


Key words: Adrenal surgery, hypercortisolism, Cushing syndrome, laparoscopic surgery.


REFERENCIAS

  1. Pera C. Cirugía de los síndromes endocrinos originados en las glándulas suprarrenales. En: Pera C, ed. Cirugía. Fundamentos, indicaciones y opciones técnicas. 3ª ed. Barcelona: Masson; 1996: 977-1007.

  2. Orth DN. Cushing´s syndrome. N Engl J Med 1995; 332: 791-803.

  3. Bergland RM, Gann DS, DeMaria EJ. Hipófisis y glándulas suprarrenales. En: Schwartz SI, Shires GT, Spencer FC, eds. Principios de cirugía. 5ª ed. México: Interamericana-McGraw-Hill; 1991: 1379-1440.

  4. Buell JF, Alexander HR, Norton JA, Yu KC, Fraker DL. Bilateral adrenalectomy for Cushing’s syndrome. Anterior versus posterior surgical approach. Ann Surg 1997; 225: 63-8.

  5. van Heerden JA, Young WF Jr, Grant CS, Carpenter PC. Adrenal surgery for hypercortisolism, surgical aspects. Surgery 1995; 117: 466-72.

  6. Brunt LM, Doherty GM, Norton JA, Soper NJ, Quasebarth MA, Moler JF. Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg 1996; 183: 1-10.

  7. Heintz A, Junginger TH, Bottger TH. Adrenalectomía endoscópica retroperitoneal. Br J Surg (ed esp) 1995; 13: 399.

  8. López-Barrios G. Tratamiento quirúrgico de las enfermedades de las glándulas suprarrenales. Trabajo de terminación de residencia, C. Habana, Hosp H Ameijeiras, 1990.

  9. Imai T, Funahashi H, Tanaka Y, Tobinaga J, Wada M, Morita-Matsuyama T et al. Adrenalectomy for treatment of Cushing’s syndrome: results in 122 patients and long-term follow-up studies. World J Surg 1996; 20: 781-6; discussion 786-7.

  10. Nakane T, Kuwayama A, Watanabe M, Takahashi T, Kato I, Ichihara K et al. Long-term results of transsphenoidal adenomectomy in patients with Cushing’s disease. Neurosurgery 1987; 21: 218-22.

  11. Burke CW, Adams CB, Esiri MM, Morris C, Bevan JS. Transsphenoidal surgery for Cushing’s disease: does what is removed determine the endocrine outcome? Clin Endocrinol (Oxf) 1990; 33: 525-37.

  12. Mampalam TJ, Tyrrell JB, Wilson CB. Transephenoidal microsurgery for Cushing’s disease. A report of 216 cases. Ann Intern Med 1988; 109: 487-93.

  13. Lindholm J. Endocrine function in patients with Cushing’s disease before and after treatment. Clin Endocrinol (Oxf) 1992; 36: 151-9.

  14. Sandler LM, Richards NT, Carr DH, Mishiter K, Joplin GF. Long term follow-up of patients with Cushing’s disease treated by interstitial irradiation. J Clin Endocrinol Metab 1987; 65: 441-7.

  15. Luton JP, Cedras S, Billaud L, Thomas G, Guilhaume B, Bertagna X et al. Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med 1990; 322: 1195-201.

  16. Favia G, Boscaro M, Lumachi F, D’Amico DF. Role of bilateral adrenalectomy in Cushing’s disease. World J Surg 1994; 18: 462-6.

  17. Nagesser SK, van Seters AP, Kievit J, Hermans J, Krans HM, van de Velde CJ. Long-term results of total adrenalectomy for Cushing’s disease. World J Surg 2000; 24: 108-13.

  18. Nagesser SK, van Seters AP, Kievit J, Hermans J, van Dulken H, Krans HM et al. Treatment of pituitary-dependent Cushing’s syndrome: long-term results of unilateral adrenalectomy followed by external pituitary irradiation compared to transsphenoidal pituitary surgery. Clin Endocrinol (Oxf) 2000; 52: 427-35.

  19. Bonjer HJ, Lange JF, Kazemier G, de Herder WW, Steyerberg EW, Bruining HA. Comparison of three techniques for adrenalectomy. Br J Surg 1997; 84: 679-82.

  20. Himpens JM. Videoendoscopy of the retroperitoneum. In: Darzi A, ed. Retroperitoneoscopy. Oxford: ISIS; 1996: 19-30.

  21. Bonjer HJ, van der Harst E, Steyerberg EW, de Herder WW, Kazemier G, Mohammedamin RSJ et al. Retroperitoneal adrenalectomy: open or endoscopic? World J Surg 1998; 22: 1246-9.

  22. Mercan S, Seven R, Ozarmagan S, Tezelman S. Endoscopic retroperitoneal adrenalectomy. Surgery 1995; 118: 1071-5; discussion 1075-6.

  23. Smith CD, Weber CJ, Amerson JR. Laparoscopic adrenalectomy: new gold standard. World J Surg 1999; 23: 389-96.

  24. Chapuis Y. Videoendoscopic adrenalectomy. Ann Chir 2000; 125: 507-10.

  25. Gagner M, Pomp A, Heniford BT, Pharand D, Lacroix A. Laparoscopic adrenalectomy: lessons learned after 100 consecutive procedures. Ann Surg 1997; 26: 238-46; discussion 246-7.

  26. Kollmorgen CF, Thompson MD, Grant CS, van Heerden JA, Byrne J, Davies ET et al. Laparoscopic versus open posterior adrenalectomy: comparison of acute-phase response and wound healing in the cushingoid porcine model. World J Surg 1998; 22: 613-9; discussion 619-20.

  27. Miccoli P, Iacconi P, Conte M, Goletti O, Buccianti P. Laparoscopic adrenalectomy. J Laparoendosc Surg 1995; 5: 221-6.

  28. Acosta E, Pantoja JP, Gamiño R, Rull JA, Herrera MF. Laparoscopic versus open adrenalectomy in Cushing’s syndrome and disease. Surgery 1999; 126: 1111-6.

  29. McCance DR, Russell CF, Kennedy TL, Hadden DR, Kennedy L, Atkinson AB. Bilateral adrenalectomy: low mortality and morbidity in Cushing’s disease. Clin Endocrinol (Oxf) 1993; 39: 315-21.

  30. Priestley JT, Sprague RG, Walters W, Salassa RM. Subtotal adrenalectomy for Cushing’s syndrome: a preliminary report of 29 cases. Ann Surg 1951; 134: 464-72; discussion 473-5.

  31. Grabner P, Hauer-Jensen M, Jervell J, Flatmark A. Long-term results of treatment for Cushing’s disease by adrenalectomy. Eur J Surg 1991; 157: 461-4.

  32. Sarkar R, Thompson NW, McLeod MK. The role of adrenalectomy in Cushing’s syndrome. Surgery 1990; 108: 1079-84.

  33. Tyrrell JB. Valoración de la función corticosuprarrenal por el laboratorio. Síndrome de Cushing. En: Wyngaarden JB, Smith LH, eds. Cecil. Tratado de Medicina Interna. 18ª ed. México. Interamericana-McGraw-Hill; 1991: 1497-1500.

  34. Pivonello R, Faggiano A, Di Salle F, Filippella M, Lombardi G, Colao A. Complete remission of Nelson’s syndrome after 1-year treatment with cabergoline. J Endocrinol Invest 1999; 22: 860-5.

  35. Salinas A, Lorenzo J, Segura M, Hernández I, Pastor J, Virseda J. Patología quirúrgica suprarrenal. Experiencia de diez años y revisión de la literatura. Arch Esp Urol 1998; 51: 227-40.

  36. Young WF. Laparoscopic adrenalectomy: an endocrinologist’s perspective. Endocrinol Diabetes 1999; 6: 199-203.






>Journals >Cirujano General >Year 2002, Issue 3
 

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