Quality of life after laparoscopic bilateral adrenalectomy for Cushing's disease.
BACKGROUND
Bilateral adrenalectomy to control symptoms of Cushing's disease after failed transsphenoidal operation is effective. We examined surgical outcomes and quality of life after laparoscopic bilateral adrenalectomy for the treatment of Cushing's disease.


METHODS
Eighteen patients underwent laparoscopic bilateral adrenalectomy from November 1994 through December 2000. Patient data were obtained from chart reviews. Patients completed a follow-up survey including the SF-36 health survey (QualityMetric Inc, Lincoln, Neb).


RESULTS
Laparoscopic bilateral adrenalectomy was accomplished in all 18 patients. There was 1 intraoperative complication of a colotomy, and 2 postoperative complications including 1 pancreatic pseudocyst and 1 hemorrhage. Three patients died at 12, 19, and 50 months after operation. At a median follow-up of 29 months, patients reported improvement in all Cushing's-related symptoms. Nine of 11 patients who responded to the survey stated their heath was improved after adrenalectomy. Results of the SF-36 health survey showed significantly lower scores in all 8 measured parameters when compared with the general population.


CONCLUSIONS
Results of laparoscopic bilateral adrenalectomy show this procedure is comparable with open adrenalectomy in controlling symptoms of Cushing's disease. Despite patient reported improvement in health after adrenalectomy, this patient population continues to experience poor health as measured by the SF-36 when compared with the general population.
Hawn
Mary T
MT
Departments of Surgery and Internal Medicine, Oregon Health and Science University, Portland, OR, USA.
Cook
David
D
Deveney
Clifford
C
Sheppard
Brett C
BC
D000293:Adolescent; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003480:Cushing Syndrome / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone