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.
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

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.
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

No abstract available.
Humans ; Tumor Necrosis Factor-alpha

Presumed risk factors including hypertension, hyperlipidemia, high hematocrit and high hemoglobin was retrospectively studied in 260 strokes (125 cerebral infarction, 79 Intracerebral hemorrhage, 56 subarachnoid hemorrhage) and 266 age and sex matched neurological inpatients controls from 1985 Mar. to 1988 Feb. in Keiymung University Dongsan Hospital. The frequency of hypertension is significantly higher in patients of intracerebral hemorrhage and subarachnoid hemorrhage but not significantly higher in patients of cerebral infarction. The level of serum total lipids, beta-lipoproteins and total cholesterols is significantly higher in patients of cerebral infarction but the level of serum triglyceride, HDL-cholesterol and the ratio of total cholesterol and HDL-cholesterol is not correlated with cerebral infarction. The level of hematocrit and hemogiobin is significantly higher in patients of cerebral infarction and subarachnoid hemorrhage. These results suggest hypertension, hyperlipidemia, high hematocrit and high hemoglobin may be risk factors of stroke in Korea as well as in Western countries.
Cerebral Hemorrhage ; Cerebral Infarction ; Cholesterol ; Hematocrit ; Humans ; Hyperlipidemias ; Hypertension ; Inpatients ; Korea ; Lipoproteins, LDL ; Retrospective Studies ; Risk Factors* ; Stroke* ; Subarachnoid Hemorrhage ; Triglycerides