OUR EXPERIENCE OF BILATERAL ADRENALECTOMY FOR CUSHING'S SYNDROME

Abstract

Aim of study: to analyze the results of bilateral adrenalectomy for Cushing's syndrome. Material and methods: Of the analyzed 16 cases of bilateral adrenalectomy, in 14 it was performed in stages (in 11 cases with Cushing's disease after unsuccessful transsphenoidal adenomectomy, in 2 - with ectopic Cushing's syndrome, in 1 - with bilateral corticosteroma), and in two - simultaneously (in 2 cases with bilateral corticosteroma). The age of the patients averaged 30.1±4.1 years. In 4 cases, bilateral adrenalectomy was performed transabdominally, and in 28 cases - retroperitoneoscopically. Results: The median follow-up period was 35.5 months. After bilateral adrenalectomy, the vast majority (75%) of patients lost excess weight and achieved a BMI <25 (P < 0.001). A statistically significant improvement was also observed in arterial hypertension (from 93.75% to 50%) (P < 0.005). Before the operation, 56.25% suffered from diabetes mellitus, and after the operation - 18.5%. Acute adrenal insufficiency developed in 25% of patients. Death during the observation period was observed in 18.7% of cases.