Past and present in abdominal surgery management for Cushing's syndrome
Vilallonga, Ramon (Hospital Universitari Vall d'Hebron)
Zafón, Carles (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Fort, José Manuel (Hospital Universitari Vall d'Hebron)
Mesa Manteca, Jordi (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Armengol Carrasco, Manuel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2014
Resum:	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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adrenal surgery ; Cushing's syndrome ; Evolution
Publicat a:	SAGE Open Medicine, Vol. 2 (march 2014) , ISSN 2050-3121

DOI: 10.1177/2050312114528905
PMID: 26770719

7 p, 542.4 KB

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