Laparoscopic adrenalectomy in patients with subclinical Cushing syndrome
Abstract
Background Subclinical Cushing syndrome in patients with adrenal incidentalomas has been associated with an increased prevalence of the metabolic syndrome and cardiovascular risk. The management of these patients, be it conservative or surgical, is still debated, but there is accumulating evidence that surgery is best and that laparoscopic adrenalectomy, when possible, is the most preferred procedure. Here we present the short- and long-term results of laparoscopic adrenalectomy for subclinical Cushing syndrome and determine the effect of this procedure on components of the metabolic syndrome.Methods Twenty-nine patients, 8 men and 21 women with adrenal incidentalomas and subclinical Cushing syndrome who underwent laparoscopic adrenalectomy, were studied retrospectively. They had undergone postoperative follow-up for improvement or worsening of their arterial blood pressure, body weight, and fasting glucose level for a mean period of 77 months.Results Preoperatively, 17 patients (58.6 %) had arterial hypertension, 14 (48.3 %) had a body mass index exceeding 27 kg/m(2), and 12 (41.4 %) had diabetes mellitus. Postoperatively, a decrease in mean arterial pressure was found in 12 patients (70.6 %), a decrease in body mass index in 6 patients (42.9 %), and an improvement in glycemic control in 5 patients (41.7 %).Conclusions Laparoscopic adrenalectomy is beneficial in many patients with subclinical Cushing syndrome because it reduces arterial blood pressure, body weight, and fasting glucose levels. Prospective randomized studies are needed to compare laparoscopic adrenalectomy with a conservative approach and to confirm these results.
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Most studies of surgical intervention for ACS involve small numbers and are retrospective, uncontrolled, and lack randomization.
“Several studies have reported the outcome of surgical intervention but most involve small numbers and are retrospective, uncontrolled, and lack randomization (230,243,250-253,255) (Table 7).”
From Adrenal incidentaloma (2020) · cites this paper as [250]
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BackgroundЛапароскопическая резекция надпочечника
Nychytaylo, М. Y., Chorny, V., Gulko, O. N., Kvachenyuk, D. A., Suprun, I. S., Kv, N., & Kvachenyuk, D. A. (2013) · UKRAINIAN JOURNAL OF SURGERY · doi:10.22141/1997-2938.4.23.2013.86690
- Authors
- Perysinakis, I., Marakaki, C., Avlonitis, S., Katseli, A., Vassilatou, E., Papanastasiou, L., Piaditis, G., & Zografos, G. N.
- Affiliations
- General Hospital of Athens G. Genimatas (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Zografos, George N.
- Venue
- Surgical Endoscopy
- Published
- 2013-01-26
- Volume
- 27
- Issue
- 6
- Pages
- 2145-2148
- ISSN
- 0930-2794 (ISSN-L)
- 1432-2218
- OpenAlex
- W1993921340
- Cited by
- 30
- References
- 25
- Citations by year
- 2024: 2 · 2023: 1 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 6 · 2014: 5 · 2013: 1
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Surgical Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- subclinical Cushing's syndrome, laparoscopic adrenalectomy, adrenal incidentaloma, metabolic syndrome, hypertension, body mass index, fasting blood glucose, glycemic control, long-term outcomes
- MeSH terms
- Adrenalectomy, Adult, Aged, Cushing Syndrome, Female, Humans, Hypertension, Male, Middle Aged, Laparoscopy, Retrospective Studies
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