title: Long-term outcomes of laparoscopic adrenalectomy for Cushing disease.
abstract: BACKGROUND
  In the surgical management of the patients with Cushing syndrome (CS), minimal invasive adrenalectomy (MA) has become the procedure of choice to treat adrenal tumors with a benign appearance ≤6 cm in diameter. Authors evaluated medium- and long-term outcomes of laparoscopic adrenalectomy (LA) for CS or subclinical CS (sCS), performed for ten years in an endocrine surgery unit.
  
  
  METHODS
  We retrospectively reviewed 21 consecutive patients undergone LA for CS or sCS from 2003 to 2013. Postoperative clinical and cardiovascular status modifications and surgical medium and long-term outcomes were analyzed.
  
  
  RESULTS
  In each patient surgery determined a normalization of the hormonal profile. There was no mortality neither major post-operative complications. Mean operative time was higher during the learning curve, there was no conversion, and morbidity rate was 6.3%. Regression of the main clinical symptoms occurred slowly in twelve months.
  
  
  CONCLUSIONS
  LA is a safe, effective and well-tolerated procedure for the treatment of CS and sCS reducing arterial blood pressure, body weight and fasting glucose levels. Following the learning curve a morbidity rate similar to that reported in the MA series for other adrenal diseases is observed.
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy. Electronic address: giovanni.conzo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Cardio-Thoracic and Respiratory Science, Endocrinology Unit, Second University of Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pasquali
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambardella
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Della Pietra
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Esposito
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Napolitano
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Tartaglia
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mauriello
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Thomas
authors.affiliation: University of Bari School of Medicine, Department of Emergency and Organs Transplantation, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pezzolla
authors.affiliation: Department of Cardio-Thoracic and Respiratory Science, Endocrinology Unit, Second University of Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Science, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen.Giordano Orsini 42, 80132 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
authors.affiliation: Department of Cardio-Thoracic and Respiratory Science, Endocrinology Unit, Second University of Naples, Italy.
authors.forename: Antonio Agostino
authors.initials: AA
authors.lastname: Sinisi
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D001835:Body Weight; D003480:Cushing Syndrome / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult