title: Laparoscopic Subcutaneous Transposition of a Pedicled Adrenal for ACTH-Independent Bilateral Macronodular Adrenal Hyperplasia.
abstract: OBJECTIVE
  Bilateral adrenalectomy or unilateral adrenalectomy and contralateral partial adrenalectomy are indicated for the treatment of ACTH-independent macronodular adrenal hyperplasia. Independent of the surgical procedure, the prognosis is poor. This article discusses a new treatment method and its efficacy for treating nodular adrenal hyperplasia.
  
  
  METHODS
  We performed a retrospective review of the medical records of 12 patients operated on between January 2008 and October 2014 at the First Affiliated Hospital of Zhengzhou University. All patients were treated by laparoscopic subcutaneous transposition of a pedicled adrenal. We performed postoperative monitoring of patients, including clinical symptoms and 24-hour levels of serum-free and urinary-free cortisol.
  
  
  RESULTS
  All 12 patients were pathologically confirmed to have nodular adrenal hyperplasia and were followed for an average of 45.5 months (range 24-60 months). The clinical symptoms of all patients disappeared, and the 24-hour plasma-free cortisol and urinary-free cortisol levels were within the normal range.
  
  
  CONCLUSIONS
  Laparoscopic subcutaneous transposition of a pedicled adrenal is a new and effective method for treating bilateral macronodular adrenal hyperplasia and can achieve long-term remission of Cushing's syndrome.
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Tian Biao
authors.initials: TB
authors.lastname: Zhang
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Wei Xing
authors.initials: WX
authors.lastname: Zhang
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Yang Yang
authors.initials: YY
authors.lastname: Sun
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Chao Liang
authors.initials: CL
authors.lastname: Wang
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Dong Hui
authors.initials: DH
authors.lastname: Jia
authors.affiliation: Department of Urology, The First Affiliated Hospital Of Zhengzhou University , Zhengzhou, P.R. China .
authors.forename: Jing
authors.initials: J
authors.lastname: Lian
mesh_terms: D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D003480:Cushing Syndrome / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006854:Hydrocortisone