ACTH-dependent Cushing syndrome: The potential benefits of simultaneous bilateral posterior retroperitoneoscopic adrenalectomy.

摘要

Bilateral adrenalectomy can provide definitive cure of hypercortisolism in persistent or recurrent Cushing's disease after unsuccessful pituitary surgery, irradiation or both, in nonresectable, corticotrophin-secreting neoplasms and in primary adrenal bilateral disease. Laparo-scopic adrenalectomy has become the standard option for benign adrenal lesions, especially in patients with Cushing's syndrome. For bilateral adrenalectomy, the standard laparo-scopic flank approach is associated with longer operative , time compared with conventional surgery, because of the need to reposition the patient after removing the first gland. Ah alternative technique is represented by the posterior, retroperitoneoscopic approach (PRA), which eliminates the need to reposition the patient.