Long-term outcomes of laparoscopic adrenalectomy for Cushing disease

Int J Surg. 2014:12 Suppl 1:S107-11. doi: 10.1016/j.ijsu.2014.05.036. Epub 2014 May 23.

Abstract

Introduction: In the surgical management of the patients with Cushing syndrome (CS), minimal invasive adrenalectomy (MA) has become the procedure of choice to treat adrenal tumors with a benign appearance ≤6 cm in diameter. Authors evaluated medium- and long-term outcomes of laparoscopic adrenalectomy (LA) for CS or subclinical CS (sCS), performed for ten years in an endocrine surgery unit.

Methods: We retrospectively reviewed 21 consecutive patients undergone LA for CS or sCS from 2003 to 2013. Postoperative clinical and cardiovascular status modifications and surgical medium and long-term outcomes were analyzed.

Results: In each patient surgery determined a normalization of the hormonal profile. There was no mortality neither major post-operative complications. Mean operative time was higher during the learning curve, there was no conversion, and morbidity rate was 6.3%. Regression of the main clinical symptoms occurred slowly in twelve months.

Conclusions: LA is a safe, effective and well-tolerated procedure for the treatment of CS and sCS reducing arterial blood pressure, body weight and fasting glucose levels. Following the learning curve a morbidity rate similar to that reported in the MA series for other adrenal diseases is observed.

Publication types

  • Evaluation Study

MeSH terms

  • Adrenal Gland Neoplasms / surgery
  • Adrenalectomy / adverse effects
  • Adrenalectomy / methods*
  • Adult
  • Aged
  • Body Weight
  • Cushing Syndrome / surgery*
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult