Adrenal surgery was performed on 162 cases of various diseases, including 67 primary
aldosteronism (
PA), 22 adrenal
Cushing's syndrome (ACS), 19 hypophyseal
Cushing's syndrome (HCS) and 32
pheochromocytoma (Pheo), at Tohoku University School of Medicine from December 1956 to March 1976. The diagnosis, treatments and prognosis of these cases were surveyed. The diagnostic accuracy of
pneumoretroperitoneum with tomography was 63% in PA, 95% in ACS and 93% in Pheo, while that of adrenal scintigraphy was 86% in PA and 100% in ACS. Scintigraphy and
aldosterone assay in venous blood samples the most reliable for the localization of PA. The unilateral approach was the most suitable procedure for the removal of adrenal
tumors in PA, ACS and single Pheo within a few hundred grams. The anterior approach was preferable for single Pheo over a few hundred grams and bilateral or multiple Pheo. As regards the treatment for HCS, good results were obtained by a combination
therapy of bilateral subtotal
adrenalectomy, hypophyseal radiation and
reserpine administration. Two cases of Pheo were inoperable. There were 3 deaths immediately after the removal of Pheo. We later investigated the blood pressure in successfully treated cases.
Hypertension was noticed in 18% of PA and 10% of ACS. No hypertensive case was found in Pheo.