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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
4
|
| pubmed:dateCreated |
1995-5-19
|
| pubmed:abstractText |
Of 206 patients with Cushing's syndrome observed from 1975 through 1991, 144 (69.9%) had pituitary-dependent Cushing's disease. Of the 110 patients who underwent pituitary surgery, 31 (28%) developed an early recurrence and 23 patients (20%) had a late relapse 1 to 5 years after primary pituitary exploration. We performed a one- or two-step total bilateral adrenalectomy in 43 patients-9 men and 34 (79.4%) women, with an average age of 47.5 years (range 13-58 years). Thirty-three of these patients had already been treated by previous transsphenoidal surgery or alternatively by external pituitary irradiation over a period of 1 to 10 years prior to adrenal surgery. Thirty-one patients underwent adrenalectomy by a double lumbar access or left lumbar and right subcostal incisions. In our series of 55 operations, perioperative complications included two splenectomies and two hemorrhages (7.3%). The early mortality rate was 3.6% (two patients). Minor complications consisted of wound infection (13.5%), bronchopneumonia or pneumothorax (four cases) with a 7- to 12-day longer hospital stay. Nelson syndrome occurred in 6 of 41 patients (14.6%). We therefore believe that bilateral adrenalectomy does play a major role in the treatment of patients with pituitary-dependent Cushing's disease unsuccessfully managed by transphenoidal surgery. It represents the definitive therapy for those patients in whom hypophysectomy was not able to provide satisfactory control of the disease.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:issn |
0364-2313
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
18
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
462-6
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:7725729-Adolescent,
pubmed-meshheading:7725729-Adrenalectomy,
pubmed-meshheading:7725729-Adult,
pubmed-meshheading:7725729-Cushing Syndrome,
pubmed-meshheading:7725729-Female,
pubmed-meshheading:7725729-Humans,
pubmed-meshheading:7725729-Hypophysectomy,
pubmed-meshheading:7725729-Male,
pubmed-meshheading:7725729-Pituitary Irradiation,
pubmed-meshheading:7725729-Recurrence
|
| pubmed:articleTitle |
Role of bilateral adrenalectomy in Cushing's disease.
|
| pubmed:affiliation |
Cattedra di Endocrinochirurgia, Istituto di Clinica Chirurgica I, Padua, Italy.
|
| pubmed:publicationType |
Journal Article
|