Adrenal surgery for hypercortisolism- surgical aspects

Jon A. van Heerden, William Francis Young, Clive S. Grant, Paul C. Carpenter

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background. Patients with endogenous hypercortisolism are thought to be at high risk for adrenalectomy and may experience significant postoperative surgical mortality/morbidity. Methods From 1981 through 1991, 91 patients underwent adreral resection for endogenous hypercortisolism. Causes were adrenal-dependent Cushing's syndrome (50%), pituitary-dependent Cushing's syndrome (27%), and an ectopic adrenocorticotropic hormone-secreting tumor(23%). Causes of adrenal-dependent Cushing's syndrome were adrenocortical adenoma (72%), bilateral nodular hyperplasia (20%), and adrenocortical carcinoma (8%). Comparative mean length of hospitalization for patients undergoing unilateral anterior versus posterior approach was 8 versus 6 days, and bilateral anterior versus posterior was 11 versus 6 days. Results. Operative mortality was 2.6%. Only one patient had a wound infection, and no patient had either a venous thrombosis or a pulmonary embolism. Delayed wound healing occurred in three patients. Conclusions. (1) Adrenal surgery can be performed today with low morbidity/mortality. (2) Although there is an effect of hypercortisolism on wound healing, infection, diabetes, hypertension, coronary artery disease, and pulmonary embolism, it was possible to perform adrenalectomy surgically with acceptable morbidity and mortality. (3) These results may serve as a standard against which laparoscopic adrenalectomy may be compared.

Original languageEnglish (US)
Pages (from-to)466-472
Number of pages7
JournalSurgery
Volume117
Issue number4
DOIs
StatePublished - 1995

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Cushing Syndrome
Adrenalectomy
Mortality
Wound Infection
Morbidity
Pulmonary Embolism
Wound Healing
Ectopic Hormones
Adrenocortical Adenoma
Adrenocortical Carcinoma
Pituitary ACTH Hypersecretion
Venous Thrombosis
Adrenocorticotropic Hormone
Hyperplasia
Coronary Artery Disease
Hospitalization
Hypertension
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

van Heerden, J. A., Young, W. F., Grant, C. S., & Carpenter, P. C. (1995). Adrenal surgery for hypercortisolism- surgical aspects. Surgery, 117(4), 466-472. https://doi.org/10.1016/S0039-6060(05)80069-8

Adrenal surgery for hypercortisolism- surgical aspects. / van Heerden, Jon A.; Young, William Francis; Grant, Clive S.; Carpenter, Paul C.

In: Surgery, Vol. 117, No. 4, 1995, p. 466-472.

Research output: Contribution to journalArticle

van Heerden, JA, Young, WF, Grant, CS & Carpenter, PC 1995, 'Adrenal surgery for hypercortisolism- surgical aspects', Surgery, vol. 117, no. 4, pp. 466-472. https://doi.org/10.1016/S0039-6060(05)80069-8
van Heerden, Jon A. ; Young, William Francis ; Grant, Clive S. ; Carpenter, Paul C. / Adrenal surgery for hypercortisolism- surgical aspects. In: Surgery. 1995 ; Vol. 117, No. 4. pp. 466-472.
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