title: Past and present in abdominal surgery management for Cushing's syndrome.
abstract: BACKGROUND
  Data on specific abdominal surgery and Cushing's syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn's syndrome and Cushing's syndrome.
  
  
  CONCLUSIONS
  Medical treatment for Cushing's syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon's experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing's syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon's experience, tumour size and optimal technique can affect the outcomes of this surgery.
authors.affiliation: Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Universitary Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Vilallonga
authors.affiliation: Department of Endocrinology, Universitary Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Diabetes and Metabolism Research Unit (VHIR), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Zafon
authors.affiliation: Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Universitary Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Barcelona, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Fort
authors.affiliation: Department of Endocrinology, Universitary Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Diabetes and Metabolism Research Unit (VHIR), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Mesa
authors.affiliation: Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Universitary Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Armengol
keywords: Adrenal surgery; Cushing’s syndrome; evolution