Role of adrenalectomy in treating recurrent Cushing′s disease: A report of 43 cases
10.3760/cma.j.issn.1000-6702.2011.06.001
- VernacularTitle:肾上腺全切术治疗复发性库欣病的疗效分析
- Author:
Xuefei DING
;
Guangchen ZHOU
;
Hanzhong LI
;
Weigang YAN
- Publication Type:Journal Article
- Keywords:
Cushing disease;
Adrenalectomy;
Surgical procedures,elective
- From:
Chinese Journal of Urology
2011;32(6):365-367
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of laparoscopic adrenalectomy and open adrenalectomy in treating recurrent Cushing′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 retrospectively analyzed. Patients completed the follow-up survey including a 36 item short-form (SF-36) health survey. Results All 43 patients achieved successful adrenalectomies without intraoperative complication. The duration of the LA was significantly shorter than that for the OA. Intraoperative blood loss was low in both groups. Median length of hospital stay was shorter in the laparoscopic adrenalectomy group, P<0.05. The median follow-up was 48.5 mon. Of the 34 (79.1%) patients available for follow-up, 22 (64.7%) had an adrenocorticotropic hormone levels >200 ng/ml and six (27.3%) had clinical Nelson syndrome. Thirty-four patients who completed the SF-36 survey reported that they felt their health status had changed from good to excellent after adrenalectomy. However, except for social activity, they showed significantly lower SF-36 scores compared with the general population, P<0.05. No statistical difference was found in SF-36 scores between the laparoscopic and open groups. Conclusions Adrenalectomy is safe and an effective option in the treatment of recurrent Cushing′s disease. It can help patients to improve both survival rate and quality of life.
