Abstract | BACKGROUND: METHODS: Forty-three patients (29 women, 14 men) with recurrent Cushing's disease after transsphenoidal operation underwent laparoscopic (n = 32) or open (n = 11) adrenalectomy from 2000 to 2008. Surgical results were evaluated for all the 43 patients. Patients completed a follow-up survey, including the short-form 36-item (SF-36) health survey. RESULTS: All the 43 patients achieved clinical reversal of hypercortisolism after adrenalectomy. Time to symptom resolution varied from a few weeks to up to 3 years. Most physical changes had resolved by a mean of 8 months after surgery. These conditions were not significantly different between the laparoscopy and open groups. Median length of hospital stay was shorter in the laparoscopy group (4 vs. 9 days; P < 0.001). Median follow-up was 48.5 months. Of the 34 (79%) patients available for follow-up, 22 (65%) had adrenocorticotropic hormone levels > 200 ng/ml and 6 (27%) had clinical Nelson syndrome. Four patients died by 75 months after surgery. Using SF-36, 30 (88%) patients reported they felt their health status was good to excellent compared with 1 year before adrenalectomy; however, they showed significantly lower scores in all the 8 SF-36 parameters compared with the general population. No significant difference emerged in SF-36 scores between the laparoscopy and open groups. CONCLUSIONS:
Adrenalectomy showed high survival and clinical benefits in recurrent Cushing's disease patients. Despite patient-reported improvement in health after adrenalectomy, patients continue to experience poor health status compared with the general population.
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Authors | Xue-Fei Ding, Han-Zhong Li, Wei-Gang Yan, Ying Gao, Xiao-Qiang Li |
Journal | Chinese medical journal
(Chin Med J (Engl))
Vol. 123
Issue 13
Pg. 1658-62
(Jul 2010)
ISSN: 2542-5641 [Electronic] China |
PMID | 20819624
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adrenalectomy
(methods)
- Adult
- Aged
- Cushing Syndrome
(surgery)
- Female
- Humans
- Male
- Middle Aged
- Young Adult
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