{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:31:37Z","timestamp":1772915497721,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1994,7,1]],"date-time":"1994-07-01T00:00:00Z","timestamp":773020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1994,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Of 206 patients with Cushing's syndrome observed from 1975 through 1991, 144 (69.9%) had pituitary\u2010dependent Cushing's disease. Of the 110 patients who underwent pituitary surgery, 31 (28%) developed an early recurrence and 23 patients (20%) had a late relapse 1 to 5 years after primary pituitary exploration. We performed a one\u2010 or two\u2010step total bilateral adrenalectomy in 43 patients\u20149\u00a0men and 34 (79.4%) women, with an average age of 47.5 years (range 13\u201358 years). Thirty\u2010three of these patients had already been treated by previous transsphenoidal surgery or alternatively by external pituitary irradiation over a period of 1 to 10 years prior to adrenal surgery. Thirty\u2010one patients underwent adrenalectomy by a double lumbar access or left lumbar and right subcostal incisions. In our series of 55 operations, perioperative complications included two splenectomies and two hemorrhages (7.3%). The early mortality rate was 3.6% (two patients). Minor complications consisted of wound infection (13.5%), bronchopneumonia or pneumothorax (four cases) with a 7\u2010 to 12\u2010day longer hospital stay. Nelson syndrome occurred in 6 of 41 patients (14.6%). We therefore believe that bilateral adrenalectomy does play a major role in the treatment of patients with pituitary\u2010dependent Cushing's disease unsuccessfully managed by trans\u2010sphenoidal surgery. It represents the definitive therapy for those patients in whom hypophysectomy was not able to provide satisfactory control of the disease.<\/jats:p>","DOI":"10.1007\/bf00353737","type":"journal-article","created":{"date-parts":[[2004,10,31]],"date-time":"2004-10-31T06:46:34Z","timestamp":1099205194000},"page":"462-466","source":"Crossref","is-referenced-by-count":28,"title":["Role of bilateral adrenalectomy in Cushing's disease"],"prefix":"10.1002","volume":"18","author":[{"given":"Gennaro","family":"Favia","sequence":"first","affiliation":[{"name":"Cattedra di Endocrinochirurgia Istituto di Clinica Chirurgica I Via Giustiniani 2 35128 Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Boscaro","sequence":"additional","affiliation":[{"name":"Cattedra di Endocrinochirurgia Istituto di Clinica Chirurgica I Via Giustiniani 2 35128 Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Lumachi","sequence":"additional","affiliation":[{"name":"Cattedra di Endocrinochirurgia Istituto di Clinica Chirurgica I Via Giustiniani 2 35128 Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide F.","family":"D'Amico","sequence":"additional","affiliation":[{"name":"Cattedra di Endocrinochirurgia Istituto di Clinica Chirurgica I Via Giustiniani 2 35128 Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1994,7]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"137","article-title":"The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)","volume":"50","author":"Cushing H.W.","year":"1932","journal-title":"Bull. 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