[Effects of adrenalectomy on the treatment of Cushing disease].
OBJECTIVE
To discuss the effects of adrenalectomy (ADX) on the treatment of Cushing's disease(CD).


METHODS
Clinical data of 15 cases of CD between January 1980 and December 2005 were analyzed to evaluate operative indications, complications and the changes of hypercortisolism and hormone levels pre- and post- adrenalectomy.


RESULTS
All the patients involved underwent transsphenoidal pituitary surgery previously. Repeated transsphenoidal surgery was performed in 4 cases. Pituitary radiotherapy was done in 4 cases. The average time from original transsphenoidal operation to ADX was 25.7 months. Pre- and post- adrenalectomy serum cortisol median level were 1156.4 nmol/L and 99.4 nmol/L, the 24 h urinary-free cortisol median level were 315.0 and 5.4 microg, respectively. Hormone replacement therapy was needed in all cases. Average follow-up period was 47 months (9-120 months). Nelson syndrome (NS) appeared in 5 cases (33.3%), while 10 cases showed no NS.


CONCLUSIONS
ADX is an effective and symptomatic treatment to relieve hypercortisolism caused by CD but with the risk of NS. Longtime hormone replacement therapy and follow up are needed after ADX.
Xing
Bing
B
Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhang
Nan
N
Ren
Zu-yuan
ZY
Su
Chang-bao
CB
Wang
Ren-zhi
RZ
Yang
Yi
Y
Ma
Wen-bin
WB
Li
Yong-ning
YN
D000293:Adolescent; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009347:Nelson Syndrome / Q000209:etiology / Q000517:prevention & control; D047748:Pituitary ACTH Hypersecretion / Q000097:blood / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone