title: Laparoscopic adrenalectomy for Cushing's syndrome: a 12-year experience.
abstract: OBJECTIVE
  The outcome after laparoscopic adrenalectomy in 51 patients with pre-Cushing's and Cushing's syndrome was evaluated at six months and one year of follow-up.
  
  
  METHODS
  In this retrospective analysis of 51 patients (35 females and 16 males) selected for laparoscopic adrenalectomy (28 left and 23 right adrenal glands), clinical presentation, endocrine and blood chemistry and hemodynamics, and pre- and postsurgical management were analyzed. Evaluations included, blood pressure, body-mass index (BMI), lipid profile, blood glucose (fasting insulin and oral glucose tolerance test [OGTT]), liver function and hormonal profile (17-hydroxyprogesterone, dehydroepiandrosterone sulfate and cortisol), and perioperative complications.
  
  
  RESULTS
  Follow-up assessment showed a significant reduction in systolic (12.34 mm Hg) and diastolic blood pressure (11.09 mm Hg), a statistically significant decrease in total (11.67 mg/dL) and a statistically significant increase in high-density lipoprotein (HDL) cholesterol (6.46 mg/dL), and a statistically significant decrease in blood glucose at 60 minutes and an increase in insulin at 120 minutes. No statistically significant changes in the hormone profile were observed. There was a statistically significant reduction in cortisol concentration in response to the dexamethasone test. Mortality was zero and the surgical complications rate was low.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy has become the gold standard in the treatment of adrenal disease. It is a safe technique, with clinically effective results and an excellent perioperative course.
authors.affiliation: Clinic of General Surgery and Surgery Methodology, University of Marche‑Ospedali Riuniti Ancona, Italy - c.romiti@email.it.
authors.forename: C
authors.initials: C
authors.lastname: Romiti
authors.forename: M
authors.initials: M
authors.lastname: Baldarelli
authors.forename: M
authors.initials: M
authors.lastname: Cappelletti Trombettoni
authors.forename: A
authors.initials: A
authors.lastname: Budassi
authors.forename: R
authors.initials: R
authors.lastname: Ghiselli
authors.forename: M
authors.initials: M
authors.lastname: Guerrieri
mesh_terms: D000315:Adrenalectomy / Q000379:methods*; D003480:Cushing Syndrome / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors