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Retroperitoneal Adrenal-Sparing Surgery for the Treatment of Cushing’s Syndrome Caused by Adrenocortical Adenoma: 8-Year Experience With 87 Patients

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Abstract

Background

The objective of this study was to present our 8-year experience with partial adrenalectomy via the retroperitoneal approach for the treatment of Cushing’s adenoma.

Methods

A total of 93 patients who underwent adrenal surgery for Cushing’s adenoma from March 2003 to December 2010 were enrolled in this study. Preoperative, intraoperative, and postoperative variables were reviewed from the database. Student’s t test was used to analyze the continuous data, and the χ2 test was used to analyze the categoric data. A value of p < 0.05 was considered statistically significant.

Results

Adrenal-sparing surgery was performed in 87 cases (31 by open surgery, 56 by retroperitoneal laparoscopy). Six patients underwent open/laparoscopic total adrenalectomy because of recurrent disease or a large size. The cure rate in our series was 97.8%. Hypertension resolved in 34 of 64 patients (53.1%), diabetes in 7 of 27 patients (25.9%) and obesity in 28 of 48 patients (58.3%). One patient died during the postoperative period. The intraoperative complication rate for the open surgery group was significantly higher than that for the retroperitoneal laparoscopy group (9.1 vs. 1.7%).

Conclusions

The retroperitoneal approach is reliable and safe for treating Cushing’s syndrome. The laparoscopic technique can decrease the prevalence of intraoperative complications. Retroperitoneal laparoscopic partial adrenalectomy can be performed with extremely low morbidity and achieves an excellent outcome, although death may occur during the postoperative period in high-risk patients. Postoperative management plays an important role in the surgical treatment of Cushing’s syndrome.

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Authors and Affiliations

  1. Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, No. 197 Ruijin Er Road, Shanghai, 200025, China

    Hong-chao He, Jun Dai, Zhou-jun Shen, Yu Zhu, Fu-kang Sun, Yuan Shao, Rong-ming Zhang, Hao-fei Wang, Wen-bin Rui & Shan Zhong

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  1. Hong-chao He
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  2. Jun Dai
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  3. Zhou-jun Shen
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  4. Yu Zhu
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  5. Fu-kang Sun
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  6. Yuan Shao
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  7. Rong-ming Zhang
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  8. Hao-fei Wang
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  10. Shan Zhong
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Correspondence to Zhou-jun Shen.

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Jun Dai is listed as co-first author.

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He, Hc., Dai, J., Shen, Zj. et al. Retroperitoneal Adrenal-Sparing Surgery for the Treatment of Cushing’s Syndrome Caused by Adrenocortical Adenoma: 8-Year Experience With 87 Patients. World J Surg 36, 1182–1188 (2012). https://doi.org/10.1007/s00268-012-1509-0

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