Adrenal gland surgery in the treatment of hyperadrenocorticism curative effect appraisal

Objective:To elevate the treatment of hyperadrenocorticism.Methods:90 cases of hyperadrenocorticism were reviewed and summarized retrospectively including the manifestations and the follow-ups.All patients have the clinical cushing syndrome.The endocrine examinations showed the high cortisol condition.71 cases of imaging study were discovered adrenal gland tumour,Left side in which 32 examples,Right flank 34 examples;Two-sided adrenal gland tumour were 5 examples.19 cases demonstrated the bilateral adrenal gland tubercle type proliferation.Results:All patients were undergone adrenal gland surgery.In which 60 cases were adrenal gland tumour excision adds with subtotal adrenalectomy;6 cases of adrenal gland tumour excision adds with the unilateral adrenalectomy;4 cases of bilateral adrenalectomy at the same time,6 cases of successively bilateral adrenalectomy;11 cases were undergone unilateral adrenalectomy and 3 cases of bilateral subtotal excisions.The pathology demonstrated 5 cases primary pigmented nodular adrenocortical diseases(PPNAD),5 cases of adrenocorticotropin-independent macronodular adrenal hyperplasia(AIMAH),57 cases of adrenal cortex adenoma,5 cases of adrenal cortex cancer,17 cases nodular adrenal hyperplasia in which 7 cases were caused by ACTH.Conclusions:The adrenal cortex adenoma surgery effect is the best,The Cushing symptom improvement is the most remarkable.Unilateraladrenalectomy is useful in short-term internal energy alleviation metabolism symptom for the difficult cushing diseases.To treat AIMAH and PPNAD with the successive minute lateral total adrenalectomy is safer and stable.Bilateral adrenalectomy can be done at same time or unilateral adrenalectomy depending on the course of disease of ACTH and the symptoms.