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Titolo:
ROLE OF BILATERAL ADRENALECTOMY IN CUSHINGS-DISEASE
Autore:
FAVIA G; BOSCARO M; LUMACHI F; DAMICO DF;
Indirizzi:
IST CLIN CHIRURG 1,CATTEDRA ENDOCRINOCHIRURG,VIA GIUSTINIANI 2 I-35128 PADUA ITALY
Titolo Testata:
World journal of surgery
fascicolo: 4, volume: 18, anno: 1994,
pagine: 462 - 466
SICI:
0364-2313(1994)18:4<462:ROBAIC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
TERM FOLLOW-UP; PITUITARY SURGERY; BROMOCRIPTINE; MICROSURGERY; HYPERTENSION; KETOCONAZOLE; IRRADIATION; MANAGEMENT; DIAGNOSIS; FEATURES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
G. Favia et al., "ROLE OF BILATERAL ADRENALECTOMY IN CUSHINGS-DISEASE", World journal of surgery, 18(4), 1994, pp. 462-466

Abstract

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 afterprimary 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 transsphenoidal surgery. It represents the definitive therapy for those patients in whom hypophysectomy was not able to provide satisfactory control of the disease.

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Documento generato il 27/09/20 alle ore 01:04:24