ROL ACTUAL DE LA ADRENALECTOMÍA BILATERAL EN EL MANEJO DEL SÍNDROME DE CUSHING ECTÓPICO

García-Marchiñena Patricio, Nolazco José Ignacio, Gueglio Guillermo, Jurado Alberto, Wright Fernando, Beskow Axel, Cavadas Demetrio, Miguel Valeria de, Paissan Andrea

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Archivos Españoles de Urología ›› 2021, Vol. 74 ›› Issue (6) : 587-591.
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ROL ACTUAL DE LA ADRENALECTOMÍA BILATERAL EN EL MANEJO DEL SÍNDROME DE CUSHING ECTÓPICO

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OBJECTIVES: The aim of this paper is to describe the clinical features and the perioperative results of the bilateral laparoscopic adrenalectomy (BLA) of salvaje in 5 patients treated for an Ectopic Cushing Syndrome (CS) who were refractory to medical treatment.MATERIALS AND METHODS: We performed a retrospective analysis of the clinical records of our institution. Five BLAs were performed in patients with Ectopic CS refractory to medical treatment during the period from January 2009 and June 2017. All patients were evaluated by a multidisciplinary team that jointly decided the most appropriate time for surgery. The following protocol data were analyzed: age, sex, location of the secreting tumor, duration of hypercortisolism, reason for hospitalization, initial therapeutic management), biochemical data (pre-op serum cortisol, plasma ACTH and free urinary cortisol), surgical data (surgical approach, surgical time, type of surgery, need for conversion to open surgery), perioperative data (post op surgical stay, post op complications according to the Clavien-Dindo scale 14, mortality, clinical cure rate and biochemical cure rate, follow up time). RESULTS: Five patients underwent BLA. The approach for the BLA was minimally invasive, either trans peritoneal (n=3) or posterior retroperitoneoscopic (n=2). Mean hospitalization time was 23.4 days (r=4-81). None of the patients died because of surgical complications, and all of them achieved biochemical and clinical remission of their hypercortisolism after surgery. CONCLUSIONS: BLA is an effective salvage alternative to control the symptoms associated with overproduction of corticosteroids in patients with ectopic CS refractory to medical treatment.

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Cushing Syndrome / Cortisol / Bilateral Adrenalectomy / Laparoscop

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García-Marchiñena Patricio , Nolazco José Ignacio , Gueglio Guillermo , Jurado Alberto , Wright Fernando , Beskow Axel , Cavadas Demetrio , Miguel Valeria de , Paissan Andrea. ROL ACTUAL DE LA ADRENALECTOMÍA BILATERAL EN EL MANEJO DEL SÍNDROME DE CUSHING ECTÓPICO. Archivos Españoles de Urología. 2021, 74(6): 587-591

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