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Vilallonga R, Zafon C, Fort JM, et al. Past and present in abdominal surgery management for Cushing's syndrome. SAGE Open Med. 2014;2:2050312114528905doi: 10.1177/2050312114528905.
Vilallonga, R., Zafon, C., Fort, J. M., Mesa, J., & Armengol, M. (2014). Past and present in abdominal surgery management for Cushing's syndrome. SAGE open medicine, 22050312114528905. https://doi.org/10.1177/2050312114528905
Vilallonga, Ramon, et al. "Past and present in abdominal surgery management for Cushing's syndrome." SAGE open medicine vol. 2 (2014): 2050312114528905. doi: https://doi.org/10.1177/2050312114528905
Vilallonga R, Zafon C, Fort JM, Mesa J, Armengol M. Past and present in abdominal surgery management for Cushing's syndrome. SAGE Open Med. 2014 Mar 31;2:2050312114528905. doi: 10.1177/2050312114528905. eCollection 2014. PMID: 26770719; PMCID: PMC4607216.
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SAGE Open Med. 2014 Mar 31;2:2050312114528905. doi: 10.1177/2050312114528905. eCollection 2014.

Past and present in abdominal surgery management for Cushing's syndrome.

SAGE open medicine

Ramon Vilallonga, Carles Zafon, José Manuel Fort, Jordi Mesa, Manel Armengol

Affiliations

  1. Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Universitary Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Barcelona, Spain.
  2. Department of Endocrinology, Universitary Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Diabetes and Metabolism Research Unit (VHIR), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain.

PMID: 26770719 PMCID: PMC4607216 DOI: 10.1177/2050312114528905

Abstract

INTRODUCTION: Data on specific abdominal surgery and Cushing's syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn's syndrome and Cushing's syndrome.

DISCUSSION: Medical treatment for Cushing's syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon's experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing's syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible.

CONCLUSION: Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon's experience, tumour size and optimal technique can affect the outcomes of this surgery.

Keywords: Adrenal surgery; Cushing’s syndrome; evolution

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