caa a22 4500 477035280 CHVBK 20180405111303.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002689900118 doi (NATIONALLICENCE)springer-10.1007/s002689900118 Role and Operative Risk of Bilateral Adrenalectomy in Hypercortisolism [Elektronische Daten] [Yves Chapuis, Jol Pitre, Filomena Conti, Bassam Abboud, Nicole Pras-Jude, Jean-Pierre Luton] Abstract. Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 patients operated on during the last 15 years. The causes of hypercortisolism were Cushing's disease (: n = 78), ectopic ACTH syndrome ( n = 3), and primary adrenocortical nodular dysplasia (Carney-Meador syndrome) ( n = 1). Before operation 37% of the patients had severe symptoms of hypercortisolism. A bilateral posterior approach was undertaken in 58 patients, whereas 18 patients had an anterior transabdominal approach and 6 patients a laparoscopic approach. There were two operative deaths (2.4%). Postoperative complications occurred mostly in cases of advanced disease and were observed in 14 patients (17%), among whom 4 had severe complications. At long-term follow-up, one recurrence of hypercortisolism and 12 Nelson syndromes (15%) were observed. In conclusion, bilateral adrenalectomy carries an acceptable operative risk, and we recommend bilateral adrenalectomy rather than long-term suppressive therapy in patients requiring prompt and definitive control of their hypercortisolism or after pituitary surgery failure. 1996 by the Société Internationale de Chir, ugie Chapuis Yves Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Pitre Jol Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Conti Filomena Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Abboud Bassam Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Pras-Jude Nicole Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Luton Jean-Pierre Department of Endocrine and Metabolic Diseases, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut https://doi.org/10.1007/s002689900118 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900118 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chapuis Yves Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut NATIONALLICENCE 700 1- Pitre Jol Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut NATIONALLICENCE 700 1- Conti Filomena Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut NATIONALLICENCE 700 1- Abboud Bassam Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut NATIONALLICENCE 700 1- Pras-Jude Nicole Department of General and Digestive Surgery, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut NATIONALLICENCE 700 1- Luton Jean-Pierre Department of Endocrine and Metabolic Diseases, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France, FR aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer