Περίληψη:
Subclinical Cushing syndrome in patients with adrenal incidentalomas has
been associated with an increased prevalence of the metabolic syndrome
and cardiovascular risk. The management of these patients, be it
conservative or surgical, is still debated, but there is accumulating
evidence that surgery is best and that laparoscopic adrenalectomy, when
possible, is the most preferred procedure. Here we present the short-
and long-term results of laparoscopic adrenalectomy for subclinical
Cushing syndrome and determine the effect of this procedure on
components of the metabolic syndrome.
Twenty-nine patients, 8 men and 21 women with adrenal incidentalomas and
subclinical Cushing syndrome who underwent laparoscopic adrenalectomy,
were studied retrospectively. They had undergone postoperative follow-up
for improvement or worsening of their arterial blood pressure, body
weight, and fasting glucose level for a mean period of 77 months.
Preoperatively, 17 patients (58.6 %) had arterial hypertension, 14
(48.3 %) had a body mass index exceeding 27 kg/m(2), and 12 (41.4 %)
had diabetes mellitus. Postoperatively, a decrease in mean arterial
pressure was found in 12 patients (70.6 %), a decrease in body mass
index in 6 patients (42.9 %), and an improvement in glycemic control in
5 patients (41.7 %).
Laparoscopic adrenalectomy is beneficial in many patients with
subclinical Cushing syndrome because it reduces arterial blood pressure,
body weight, and fasting glucose levels. Prospective randomized studies
are needed to compare laparoscopic adrenalectomy with a conservative
approach and to confirm these results.
Συγγραφείς:
Perysinakis, Iraklis
Marakaki, Chrisanthi
Avlonitis, Spyridon
and Katseli, Anastasia
Vassilatou, Evangeline
Papanastasiou,
Lambrini
Piaditis, George
Zografos, George N.
