[Current role of bilateral adrenalectomy in Ectopic Cushing syndrome.]

Autor:	García-Marchiñena P; Servicio de Urología. Hospital Italiano de Buenos Aires. Argentina., Wright F; Servicio de Cirugía. Hospital Italiano de Buenos Aires. Argentina., Nolazco JI; Servicio de Urología. Hospital Italiano de Buenos Aires. Argentina., de Miguel V; Servicio de Endocrinología. Hospital Italiano de Buenos Aires. Argentina., Paissan A; Servicio de Endocrinología. Hospital Italiano de Buenos Aires. Argentina., Gueglio G; Servicio de Urología. Hospital Italiano de Buenos Aires. Argentina., Beskow A; Servicio de Cirugía. Hospital Italiano de Buenos Aires. Argentina., Jurado A; Servicio de Urología. Hospital Italiano de Buenos Aires. Argentina., Cavadas D; Servicio de Cirugía. Hospital Italiano de Buenos Aires. Argentina.
Jazyk:	Spanish; Castilian
Zdroj:	Archivos espanoles de urologia [Arch Esp Urol] 2021 Jul; Vol. 74 (6), pp. 587-591.
Abstrakt:	Objectives: The aim of this paper is to describe the clinical features and the perioperative results of the bilateral laparoscopic adrenalectomy (BLA) of salvaje in 5 patients treated for an Ectopic Cushing Syndrome (CS) who were refractory to medical treatment. Materials and Methods: We performed a retrospective analysis of the clinical records of our institution. Five BLAs were performed in patients with Ectopic CS refractory to medical treatment during the period from January 2009 and June 2017. All patients were evaluated by a multidisciplinary team that jointly decided the most appropriate time for surgery. The following protocol data were analyzed: age, sex, location of the secreting tumor, duration of hypercortisolism, reason for hospitalization, initial therapeutic management), biochemical data (pre-op serum cortisol, plasma ACTH and free urinary cortisol), surgical data (surgical approach, surgical time, type of surgery, need for conversion toopen surgery), perioperative data (post op surgical stay, post op complications according to the Clavien-Dindo scale 14, mortality, clinical cure rate and biochemical cure rate, follow up time). Results: Five patients underwent BLA. The approach for the BLA was minimally invasive, either trans peritoneal (n=3) or posterior retroperitoneoscopic (n=2). Mean hospitalization time was 23.4 days (r=4-81). None of the patients died because of surgical complications, and all of them achieved biochemical and clinical remission of their hypercortisolism after surgery. Conclusions: BLA is an effective salvage alter native to control the symptoms associated with overproduction of corticosteroids in patients with ectopic CS refractory to medical treatment.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu