Giovanni Conzo1, Daniela Pasquali2, Claudio Gambardella3, Cristina Della Pietra3, Daniela Esposito3, Salvatore Napolitano3, Ernesto Tartaglia3, Claudio Mauriello3, Guglielmo Thomas3, Angela Pezzolla4, Annamaria De Bellis2, Luigi Santini3, Antonio Agostino Sinisi2. 1. Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy. Electronic address: giovanni.conzo@unina2.it. 2. Department of Cardio-Thoracic and Respiratory Science, Endocrinology Unit, Second University of Naples, Italy. 3. Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy. 4. University of Bari School of Medicine, Department of Emergency and Organs Transplantation, Italy.
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.
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.
Authors: Felipe de Almeida E Paula; Ravisio Israel Dos Santos; Odivaldo Antonio Ferruzzi; Rafael Osti Melo; Mariana Takaku Journal: Int Braz J Urol Date: 2018 May-Jun Impact factor: 1.541