Jérôme Bertherat1. 1. Endocrinology Department, Center for Rare Adrenal Diseases, Cochin Hospital, AP-HP, Université Paris Cité, 75014, Paris, France. Jerome.bertherat@aphp.fr.
Abstract
INTRODUCTION: Laparoscopic bilateral adrenalectomy (BAD) is one of the treatments of Cushing's Disease (CD), but its indications and outcome is debated. METHODS: The literature on BAD was reviewed as part of a work performed for the Cushing's disease guideline. RESULTS: The surgical morbidity of BAD is reported between 10 and 18% and no mortality has been reported in the largest series. Because of the endocrine sacrifice it will be mostly performed after a multidisciplinary team discussion in selected cases of refractory CD (mostly after failure of pituitary surgery and/or medical treatment). It is also frequently discussed in female patients desiring pregnancy. Corticotroph tumor progression occurs in 40% of the patients but is in most patients manageable when detected early by a careful long term monitoring with pituitary MRI and ACTH assays after BAD. CONCLUSION: BAD is a safe and effective treatment of CD used in specific situations and requiring long term monitoring.
INTRODUCTION: Laparoscopic bilateral adrenalectomy (BAD) is one of the treatments of Cushing's Disease (CD), but its indications and outcome is debated. METHODS: The literature on BAD was reviewed as part of a work performed for the Cushing's disease guideline. RESULTS: The surgical morbidity of BAD is reported between 10 and 18% and no mortality has been reported in the largest series. Because of the endocrine sacrifice it will be mostly performed after a multidisciplinary team discussion in selected cases of refractory CD (mostly after failure of pituitary surgery and/or medical treatment). It is also frequently discussed in female patients desiring pregnancy. Corticotroph tumor progression occurs in 40% of the patients but is in most patients manageable when detected early by a careful long term monitoring with pituitary MRI and ACTH assays after BAD. CONCLUSION: BAD is a safe and effective treatment of CD used in specific situations and requiring long term monitoring.
Authors: Katrin Ritzel; Felix Beuschlein; Anne Mickisch; Andrea Osswald; Harald J Schneider; Jochen Schopohl; Martin Reincke Journal: J Clin Endocrinol Metab Date: 2013-08-16 Impact factor: 5.958
Authors: Martin Reincke; Katrin Ritzel; Andrea Oßwald; Christina Berr; Günter Stalla; Klaus Hallfeldt; Nicole Reisch; Jochen Schopohl; Felix Beuschlein Journal: Eur J Endocrinol Date: 2015-05-20 Impact factor: 6.664
Authors: Maria Fleseriu; Richard Auchus; Irina Bancos; Anat Ben-Shlomo; Jerome Bertherat; Nienke R Biermasz; Cesar L Boguszewski; Marcello D Bronstein; Michael Buchfelder; John D Carmichael; Felipe F Casanueva; Frederic Castinetti; Philippe Chanson; James Findling; Mônica Gadelha; Eliza B Geer; Andrea Giustina; Ashley Grossman; Mark Gurnell; Ken Ho; Adriana G Ioachimescu; Ursula B Kaiser; Niki Karavitaki; Laurence Katznelson; Daniel F Kelly; André Lacroix; Ann McCormack; Shlomo Melmed; Mark Molitch; Pietro Mortini; John Newell-Price; Lynnette Nieman; Alberto M Pereira; Stephan Petersenn; Rosario Pivonello; Hershel Raff; Martin Reincke; Roberto Salvatori; Carla Scaroni; Ilan Shimon; Constantine A Stratakis; Brooke Swearingen; Antoine Tabarin; Yutaka Takahashi; Marily Theodoropoulou; Stylianos Tsagarakis; Elena Valassi; Elena V Varlamov; Greisa Vila; John Wass; Susan M Webb; Maria C Zatelli; Beverly M K Biller Journal: Lancet Diabetes Endocrinol Date: 2021-10-20 Impact factor: 32.069
Authors: Sarah K Thompson; Amanda V Hayman; William H Ludlam; Clifford W Deveney; D Lynn Loriaux; Brett C Sheppard Journal: Ann Surg Date: 2007-05 Impact factor: 12.969
Authors: Philip W Smith; Kristin C Turza; Cullen O Carter; Mary Lee Vance; Edward R Laws; John B Hanks Journal: J Am Coll Surg Date: 2009-04-24 Impact factor: 6.113
Authors: Andrea Oßwald; Eva Plomer; Christina Dimopoulou; Monika Milian; Rainer Blaser; Katrin Ritzel; Anne Mickisch; Ferengis Knerr; Milan Stanojevic; Klaus Hallfeldt; Jochen Schopohl; Klaus A Kuhn; Günter Stalla; Felix Beuschlein; Martin Reincke Journal: Eur J Endocrinol Date: 2014-08 Impact factor: 6.664