{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T17:29:10Z","timestamp":1779211750067,"version":"3.51.4"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum W\u00fcrzburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>In selected cases of severe Cushing\u2019s syndrome due to uncontrolled ACTH secretion, bilateral adrenalectomy appears unavoidable. Compared with unilateral adrenalectomy (for adrenal Cushing\u2019s syndrome), bilateral adrenalectomy has a perceived higher perioperative morbidity. The aim of the current study was to compare both interventions in endogenous Cushing\u2019s syndrome regarding postoperative outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We report a single-center, retrospective cohort study comparing patients with hypercortisolism undergoing bilateral vs. unilateral adrenalectomy during 2008\u20132021. Patients with adrenal Cushing\u2019s syndrome due to adenoma were compared with patients with ACTH-dependent Cushing\u2019s syndrome (Cushing\u2019s disease and ectopic ACTH production) focusing on postoperative morbidity and mortality as well as long-term survival.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 83 patients with adrenalectomy for hypercortisolism (65.1% female, median age 53\u00a0years), the indication for adrenalectomy was due to adrenal Cushing\u2019s syndrome in 60 patients (72.2%; 59 unilateral and one bilateral), and due to hypercortisolism caused by Cushing\u2019s disease (<jats:italic>n<\/jats:italic>\u2009=\u200916) or non-pituitary uncontrolled ACTH secretion of unknown origin (<jats:italic>n<\/jats:italic>\u2009=\u20097) (27.7% of all adrenalectomies). Compared with unilateral adrenalectomy (<jats:italic>n<\/jats:italic>\u2009=\u200959), patients with bilateral adrenalectomy (<jats:italic>n<\/jats:italic>\u2009=\u200924) had a higher rate of severe complications (0% vs. 33%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and delayed recovery (median: 10.2% vs. 79.2%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Using the MTL30 marker, patients with bilateral adrenalectomy fared worse than patients after unilateral surgery (MTL30 positive: 7.2% vs. 25.0% <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Postoperative mortality was increased in patients with bilateral adrenalectomy (0% vs. 8.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.081).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>While unilateral adrenalectomy for adrenal Cushing\u2019s syndrome represents a safe and definitive therapeutic option, bilateral adrenalectomy to control ACTH-dependent extra-adrenal Cushing\u2019s syndrome or Cushing\u2019s disease is a more complicated intervention with a mortality of nearly 10%.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-022-02568-8","type":"journal-article","created":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T08:33:09Z","timestamp":1653726789000},"page":"2481-2488","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing\u2019s syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing\u2019s syndrome"],"prefix":"10.1007","volume":"407","author":[{"given":"Joachim","family":"Reibetanz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Kelm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantin L.","family":"Uttinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Schlegel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hankir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Wiegering","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph-Thomas","family":"Germer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan Friso","family":"Lock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7777-0909","authenticated-orcid":false,"given":"Armin","family":"Wiegering","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,28]]},"reference":[{"issue":"2","key":"2568_CR1","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1002\/cphy.c130035","volume":"4","author":"H Raff","year":"2014","unstructured":"Raff H, Sharma ST, Nieman LK (2014) Physiological basis for the etiology, diagnosis, and treatment of adrenal disorders: Cushing\u2019s syndrome, adrenal insufficiency, and congenital adrenal hyperplasia. 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