Role of adrenalectomy intreating recurrent Cushing ′ s disease: A report of 43cases

Abstract

：Objective To evaluatethe efficacy of laparoscopic adrenalectomy and open adrenalectomy in treating recurrentCushing′s disease. Methods Forty-three patients (29 females and 14 males)with recurrent Cushing′s disease treated with laparoscopic adrenalectomy(LA, n=32) or open (OA, n=11) adrenalectomy from 2000 to 2008 were retrospectivelyanalyzed. Patients completed the follow-up survey including a 36 item short-form (SF-36)health survey. Results All 43 patients achieved successful adrenalectomies withoutintraoperative complication. The duration of the LA was significantly shorter than thatfor the OA. Intraoperative blood loss was low in both groups. Median length of hospitalstay was shorter in the laparoscopic adrenalectomy group, P 200 ng/ml and six (27.3%) had clinical Nelsonsyndrome. Thirty-four patients who completed the SF-36 survey reported that they felttheir health status had changed from good to excellent after adrenalectomy. However,except for social activity, they showed significantly lower SF-36 scores compared with thegeneral population, P<0.05. No statistical difference was found in SF-36 scores betweenthe laparoscopic and open groups. Conclusions Adrenalectomy is safe and an effectiveoption in the treatment of recurrent Cushing′s disease. It can help patients to improve both survivalrate and quality of life. Key words: Cushing disease; Adrenalectomy; Surgical procedures,elective