OUR EXPERIENCE OF BILATERAL ADRENALECTOMY FOR ITZENKO-CUSHING SYNDROME
Keywords:
Itsenko-Cushing syndrome, bilateral adrenalectomy, transsphenoidal adenomectomy, ectopic Cushing's syndrome, bilateral corticosteromaAbstract
Purpose: to analyze the results of bilateral adrenalectomy for Itsenko-Cushing syndrome. Material and methods. From the analyzed 16 cases of bilateral adrenalectomy (AE), in 14 it was performed in stages (in 11 cases with Itsenko-Cushing's disease after unsuccessful transsphenoidal adenomectomy (TAE), in 2 - with ectopic Cushing's syndrome (ECS), in 1 - with bilateral corticosteroma), and in two cases – simultaneously (in 2 cases with bilateral corticosteroma). The age of the patients was on average 30.14±4.13 (20-38) years, the ratio of men to women was 1:1.7. in 4 cases, AE was performed transabdominally, and in 28 cases, retroperitoneoscopically. Results. The median follow-up period was 35.5 months. After AE, the vast majority (75%) of patients lost excess weight and achieved a BMI <25 (P < 0.001). A statistically significant improvement was also observed in arterial hypertension (from 93.75% to 50%) (P < 0.005). Before the operation, 56.25% suffered from diabetes mellitus, and after the operation - 18.5%. Acute adrenal insufficiency developed in 25% of patients. Death during the observation period was observed in 18.75% of cases. Conclusion. Bilateral AE is an effective method for treating manifestations of hypercortisolism in patients with SIC. It provides good palliative treatment for DIC with failed TAE and ESIC. Most patients have good survival and good quality of life. Mortality in the postoperative period is directly related to the severity of complications that develop in the preoperative period.
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Статья поступила в редакцию 25.10.2023; одобрена после рецензирования 22.12.2023; принята к публикации 25.12.2023.
The article was submitted 25.10.2023; approved after reviewing 22.12.2023; accepted for publication 25.12.2023.
Информация об авторах:
Беркинов Улугбек Базарбаевич - д.м.н., профессор кафедры хирургии Ташкентской Медицинской Академии, Ташкент, Узбекистан. Е-mail: ulugbek_b@mail.ru, https://orcid.org/00900302591713.
Сахибаев Дилшод Парпижалилович - д.м.н., доцент кафедры кафедры хирургии Ташкентской Медицинской Академии, Ташкент, Узбекистан. Е-mail: doctorsd77@mail.ru, https://orcid.org/0009-0006-2729-1153.
Омонов Жамолиддин Шарофиддинович – врач многопрофильной частной клиники ЭраМед, Ташкент, Узбекистан. Е-mail: omon_90@list.ru, https://orcid.org/0009-0008-2741-120
Джураева Мардона Меликузиевна – магистр кафедры хирургии Ташкентской Медицинской Академии, Ташкент, Узбекистан. Е-mail: jorayevamardona015@gmail.com, https://orcid.org/0009-0005-0109-4429.
Источники финансирования: Работа не имела специального финансирования.
Конфликт интересов: Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Вклад авторов:
Беркинов У.Б. — идеологическая концепция работы, написание текста; редактирование статьи;
Сахибаев Д.П. — сбор и анализ литературных источников
Омонов Ж.Ш. . — сбор и анализ литературных источников и написание части текста
Джураева М.М — сбор и анализ литературных источников и написание части текста.
Information about the authors:
Ulugbek B. Berkinov — DSc, professor of surgical department of Tashkent medical academy. Tashkent, Uzbekistan; E-mail: ulugbek_b@mail.ru, https://orcid.org/00900302591713.
Dilshod P. Sakhibayev — DSc, assistent professor of surgical department of Tashkent medical academy.Tashkent, Uzbekistan; E-mail: doctorsd77@mail.ru, https://orcid.org/0009-0006-2729-1153.
Omonov Jamoliddin Sharofiddin ogli – surgeon of multidisciplinar private clinic of EraMed. Tashkent, Uzbekistan. E-mail: omon_90@list.ru, https://orcid.org/0009-0008-2741-120
Jurayeva Mardona Melikuzi kizi – Master of surgical department of Tashkent medical academy. Tashkent, Uzbekistan. . E-mail: jorayevamardona015@gmail.com, https://orcid.org/0009-0005-0109-4429.
Sources of funding: The work did not receive any specific funding.
Conflict of interest: The authors declare no explicit or potential conflicts of interest associated with the publication of this article.
Contribution of the authors:
Berkinov U.B — ideological concept of the work, writing the text; editing the article;
Sakhibayev D.P — collection and analysis of literature sources
Omonov J.Sh — collection and analysis of literature sources and writing part of the text.
Jurayeva M.M — collection and analysis of literature sources and writing part of the text.
