Postoperative Complications of an Open Adrenalectomy in Patients with Adrenal Cushing's Syndrome.
- Author:
Shin Doe SUH
1
;
Jae Bok LEE
;
Cheung Won BAE
;
Bum Hwan KOO
Author Information
1. Department of Surgery, Korea University College of Medicine.
- Publication Type:Original Article
- Keywords:
Cushing's syndrome;
Complication;
Adrenalectomy
- MeSH:
Abdominal Abscess;
Acute Kidney Injury;
Adenoma;
Adrenalectomy*;
Cations;
Cushing Syndrome*;
Ganglioneuroma;
Hemorrhage;
Humans;
Hyperaldosteronism;
Hyperplasia;
Intestinal Pseudo-Obstruction;
Korea;
Neuroblastoma;
Pathology;
Pneumonia;
Postoperative Complications*;
Psychotic Disorders;
Pulmonary Atelectasis;
Wound Infection
- From:Journal of the Korean Surgical Society
2000;58(4):502-507
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan. 1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess, intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of 31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel opment of postoperative complication was related to the length of the operation, the size of the tumor, the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05). CONCLUSION: The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
