Adrenal autotransplantation with A-V anastomosis for treatment of Cushing's disease. A follow-up study of 31 cases.
Thirty-one patients with Cushing's disease were treated with bilateral adrenalectomy and partial left adrenal autotransplantation with A-V anastomosis. They were followed up for 1 to 5 years. Three patients failed after adrenal autotransplantation to the abdominal muscle with the left gland's central vein anastomosed to the inferior epigastric artery. Twenty-eight patients underwent adrenal autotransplantation to the omentum with the gland's vein anastomosed to the gastroepiploic artery. Steroid could be omitted a short period after operation and life-long replacement therapy was avoidable in most patients. A few patients subsequently developed hypocorticalism. Two died and one had recurrence of Cushing's disease. Clinical and animal experimental results showed that the omentum is suitable for adrenal autotransplantation with A-V anastomosis. Transabdominal bilateral adrenalectomy and adrenal autotransplantation to the omentum with A-V anastomosis are acceptable in the treatment of Cushing's disease. The subsequent development of hypocorticalism and recurrence of Cushing's syndrome are also discussed.
Miao
Y Z
YZ
Department of Urology, First Affiliated Hospital Henan Medical University, Zhengzhou.
Zhao
G X
GX
Yang
T S
TS
Gao
J G
JG
Chen
Y T
YT
D000293:Adolescent; D000311:Adrenal Glands / Q000098:blood supply / Q000637:transplantation*; D000328:Adult; D001166:Arteriovenous Shunt, Surgical; D002648:Child; D003480:Cushing Syndrome / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply / Q000637:transplantation