Effects of adrenalectomy on the treatment of Cushing disease.
- Author:
Bing XING
1
;
Nan ZHANG
;
Zu-yuan REN
;
Chang-bao SU
;
Ren-zhi WANG
;
Yi YANG
;
Wen-bin MA
;
Yong-ning LI
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adrenalectomy; adverse effects; methods; Adrenocorticotropic Hormone; blood; Adult; Child; Female; Follow-Up Studies; Humans; Hydrocortisone; blood; Male; Middle Aged; Nelson Syndrome; etiology; prevention & control; Pituitary ACTH Hypersecretion; blood; surgery; Postoperative Complications; prevention & control; Retrospective Studies; Treatment Outcome
- From: Chinese Journal of Surgery 2008;46(8):592-594
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo discuss the effects of adrenalectomy (ADX) on the treatment of Cushing's disease(CD).
METHODSClinical data of 15 cases of CD between January 1980 and December 2005 were analyzed to evaluate operative indications, complications and the changes of hypercortisolism and hormone levels pre- and post- adrenalectomy.
RESULTSAll the patients involved underwent transsphenoidal pituitary surgery previously. Repeated transsphenoidal surgery was performed in 4 cases. Pituitary radiotherapy was done in 4 cases. The average time from original transsphenoidal operation to ADX was 25.7 months. Pre- and post- adrenalectomy serum cortisol median level were 1156.4 nmol/L and 99.4 nmol/L, the 24 h urinary-free cortisol median level were 315.0 and 5.4 microg, respectively. Hormone replacement therapy was needed in all cases. Average follow-up period was 47 months (9-120 months). Nelson syndrome (NS) appeared in 5 cases (33.3%), while 10 cases showed no NS.
CONCLUSIONSADX is an effective and symptomatic treatment to relieve hypercortisolism caused by CD but with the risk of NS. Longtime hormone replacement therapy and follow up are needed after ADX.
