J Korean Surg Soc.
2000 Apr;58(4):502-507.
Postoperative Complications of an Open Adrenalectomy in Patients with Adrenal Cushing's Syndrome
- Affiliations
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- 1Department of Surgery, Korea University College of Medicine.
Abstract
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PURPOSE: An adrenalectomy is needed in about 10 to 25% of Cushing's syndrome cases due to adrenal
adenoma, hyperplasia, or carcinoma. The purpose of this study is to compare the postoperative compli
cations of an adrenalectomy between Cushing's and non-Cushing's patients. METHODS: Data were
collected by reviewing the hospital charts of patients treated at Korea University from July 1987 to Jan.
1998 the clinical data were compared using statistical method. RESULTS: An adrenalectomy was performed
in 77 patients, and the causes of the adrenalectomy were primary aldosteronism (25 cases), pheochr
mocytoma (23 cases), Cushing's syndrome (20 cases), adrenal carcinoma (5 cases), non-functioning adre
nal adenoma (2 cases), ganglioneuroma (1 case), and neuroblastoma (1 case). The causes of Cushing's
syndrome were adenoma (16 cases), nodular hyperplasia (3 cases), and carcinoma (1 case). The types
of adrenalectomy used were anterior (60 cases), posterior (14 cases), and lateral (3 cases). Postoperative
complications were atelectasis, pneumonia, wound infection, paralytic ileus, intra-abdominal abscess,
intra-abdominal bleeding, acute renal failure and psychosis, in order of frequency. The rate of post
operative complications in patients with Cushing's syndrome was 85%, which was higher than rate of
31.6% (p=0.02). Postoperative respiratory complications, such as atelectasis and pneumonias, were more
common for patients with Cushing's syndrome (p=0.02). In patients of Cushing's syndrome, the devel
opment of postoperative complication was related to the length of the operation, the size of the tumor,
the weight of the tumor, the site of the tumor, the pathology and the method of approach (p>0.05).
CONCLUSION
The patients with Cushing's syndrome were prone to postoperative complications, and respiratory complications were the most common postoperative complication. Careful preoperative and postoperative respiratory management should reduce the complications of an adrenalectomy in patients with Cushing's syndrome.
