{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:54:11Z","timestamp":1783619651192,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2007,5,30]],"date-time":"2007-05-30T00:00:00Z","timestamp":1180483200000},"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":[[2007,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Adrenalectomy continues to play an important role in the management of Cushing\u2019s syndrome (CS). Untreated CS causes considerable physical and mental morbidity and mortality. However, little information is available on the effect of adrenalectomy in ameliorating functional disabilities in CS patients. Our study assesses the long\u2010term outcome of adrenalectomy in patients with CS. This is a retrospective analysis of CS patients managed during 1990\u20132005 at a tertiary care center. We analyzed the clinical presentation, endocrine evaluation, and surgical management preoperatively and following adrenalectomy. The subjects were 37 patients with CS (age 24.5 \u00b1 15 years, range 1\u201360 years; male:female 1.0:1.2). There were various etiologies\u2014unilateral adrenocortical adenoma (<jats:italic>n<\/jats:italic> = 11), adrenocortical carcinoma (<jats:italic>n<\/jats:italic> = 13), pituitary ACTH\u2010secreting adenoma with failed transsphenoidal surgery (<jats:italic>n<\/jats:italic> = 4), ectopic unidentified ACTH source (<jats:italic>n<\/jats:italic> = 7), bilateral adrenal macronodular hyperplasia (<jats:italic>n<\/jats:italic> = 1), primary pigmented nodular adrenal hyperplasia (<jats:italic>n<\/jats:italic> = 1) \u2014for which the patients underwent adrenalectomy: unilateral (<jats:italic>n<\/jats:italic> = 22), bilateral (<jats:italic>n<\/jats:italic> = 13), or adrenonephrectomy (<jats:italic>n<\/jats:italic> = 2). Two patients died during the perioperative period owing to chest infection and sepsis. At the median follow\u2010up of 60\u00a0months (range 6\u2013144\u00a0months), the patients exhibit significant persistence of obesity (41%), proximal muscle weakness (44%), menstrual irregularity (8%), hypertension (31%), and insulin\u2010dependent diabetes (29%). Hirsutism and psychological abnormalities persisted to a lesser extent. All patients had biochemical cure of CS following surgery evidenced by the 8 a.m. basal cortisol \u2264 5 \u03bcg\/dl. The hypothalamic\u2010pituitary\u2010adrenal axis recovered as shown by normalization of the short synacthen\u2010stimulated cortisol level (peak level \u2265 20 \u03bcg\/dl) after a median follow\u2010up of 9\u00a0months (range 6\u201318\u00a0months). Incomplete clinical recovery following adrenalectomy emphasizes the need of early recognition and prompt treatment of CS. Surgery for adrenocortical adenoma is safe and effective; however, survival of patients with CS due to adrenocortical carcinoma remains poor. Bilateral adrenalectomy provides early control of hypercortisolism in selected cases of unlocalized ectopic ACTH syndrome or failed transsphenoidal surgery. Even though functional recovery is incomplete after adrenalectomy, quality of life improves considerably.<\/jats:p>","DOI":"10.1007\/s00268-007-9067-6","type":"journal-article","created":{"date-parts":[[2007,5,29]],"date-time":"2007-05-29T12:56:38Z","timestamp":1180443398000},"page":"1425-1432","source":"Crossref","is-referenced-by-count":30,"title":["Outcome of Adrenalectomy for Cushing\u2019s Syndrome: Experience from a Tertiary Care Center"],"prefix":"10.1002","volume":"31","author":[{"given":"Anand Kumar","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. K.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Post Graduate Institute of Medical Sciences Raibareli Road 226 014 Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,5,30]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(52)90027\u20102"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(82)92749\u20100"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1992.tb01437.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800580102"},{"key":"e_1_2_6_6_2","first-page":"461","article-title":"Long term results of treatment of Cushing\u2019s disease by adrenalectomy","volume":"157","author":"Grabner P","year":"1991","journal-title":"Eur J Surg"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(18)30087-2"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(61)90069\u20109"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792\u2010198101000\u201000002"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010003\u20101491\u20103"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002230010085"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.61.713.205"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03347198"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102796.1999.00483.x"},{"key":"e_1_2_6_15_2","first-page":"1088","article-title":"Long term outcome of bilateral adrenalectomy in patients with cushing\u2019s syndrome","volume":"116","author":"O\u2019Riordain DS","year":"1994","journal-title":"Surgery"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(00)04172\u20106"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689910020"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000012274"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1159\/000012396"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900119"},{"key":"e_1_2_6_21_2","first-page":"16","article-title":"Survival and causes of death after adrenalectomy for Cushing\u2019s disease","volume":"97","author":"Welbourn RB","year":"1985","journal-title":"Surgery"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.1.117"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-007-9067-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-007-9067-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-007-9067-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T11:04:29Z","timestamp":1704711869000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-007-9067-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,5,30]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2007,7]]}},"alternative-id":["10.1007\/s00268-007-9067-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-007-9067-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,5,30]]}}}