{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:08:01Z","timestamp":1784268481386,"version":"3.55.0"},"reference-count":17,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives:\u00a0Bilateral adrenalectomy (BADx) is a definitive treatment for diverse adrenal disorders, though data across etiologies remain limited. This multicenter study evaluated perioperative risks, long-term survival, and shifts in comorbidities in patients undergoing BADx for Cushing\u2019s syndrome (CS) and non-CS indications. Materials and Methods: We retrospectively analyzed 103 adult patients (CS, n\u00a0= 52; non-CS, n = 51) from 9 tertiary centers. Primary outcomes included early (\u226430 days) and late mortality, complications (adrenal crisis, Nelson\u2019s syndrome), and changes in comorbidity profiles. Results: The cohort (mean age 50.59 \u00b1 13.82 years) had a median follow-up of 96 months. Early mortality occurred exclusively in CS patients (5.8%), while late mortality was comparable between groups. Overall 5-year survival rates were 83.3% for CS and 89.9% for non-CS (p = 0.360), with no significant differences across CS etiologies (p = 0.760). Adrenal crisis was significantly more frequent in CS (23% vs. 7%, p = 0.023). Nelson\u2019s syndrome developed in 28% of Cushing\u2019s disease patients. Postoperatively, both cohorts showed increased reliance on psychiatric and cardiovascular medications. Notably, osteoporosis rates were significantly higher than preoperative levels exclusively in the non-CS group (p = 0.006), highlighting the impact of long-term glucocorticoid replacement in this cohort. Two patients with congenital adrenal hyperplasia demonstrated remarkable long-term survival (8 and 30 years) across different surgical timings. Conclusions: BADx delivers rapid systemic remission and definitive control across a range of adrenal pathologies. However, the primary cause and the timing of surgery significantly impact the clinical course and the risk of complications. The resulting state of irreversible adrenal insufficiency requires comprehensive, lifelong surveillance and tailored hormone replacement.<\/jats:p>","DOI":"10.3390\/medicina62071373","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:32:17Z","timestamp":1784266337000},"page":"1373","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Risks and Long-Term Outcomes of Bilateral Adrenalectomy: A Multicenter Retrospective Cohort Study Across Cushing\u2019s Syndrome and Non-Cushing Etiologies"],"prefix":"10.3390","volume":"62","author":[{"given":"G\u00f6k\u00e7en","family":"G\u00fcng\u00f6r Semiz","sequence":"first","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nusret","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Akdeniz University, Antalya 07070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5145-0920","authenticated-orcid":false,"given":"Mustafa","family":"Aydemir","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Akdeniz University, Antalya 07070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0732-4764","authenticated-orcid":false,"given":"\u00d6zlem","family":"Soyluk Sel\u00e7ukbiricik","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, \u0130stanbul University, Istanbul 34093, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"\u015earer Y\u00fcrekli","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35040, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"\u00d6z\u0131\u015f\u0131k","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35040, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00fcheyla","family":"G\u00f6rar","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fczin","family":"Fidan Yaylal\u0131","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Pamukkale University, Denizli 20070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eda","family":"Ert\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Adana Hospital, Ba\u015fkent University School of Medicine, Adana 01120, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"\u00d6ner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Marmara University Pendik Training and Research Hospital, Istanbul 34899, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selin","family":"Gen\u00e7","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Turgut Ozal Medical Center, Faculty of Medicine, Inonu University, Malatya 44280, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-5129","authenticated-orcid":false,"given":"Mehmet Emin","family":"Arayici","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35340, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eeyhmus","family":"Abakay","sequence":"additional","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet \u00c7a\u011fr\u0131","family":"\u00dcnal","sequence":"additional","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdurrahman","family":"\u00c7\u00f6mlek\u00e7i","sequence":"additional","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Yener","sequence":"additional","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik","family":"Demir","sequence":"additional","affiliation":[{"name":"Division\u00a0of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir 35340,\u00a0Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3939","DOI":"10.1210\/jc.2013-1470","article-title":"Clinical review: Outcome of bilateral adrenalectomy in Cushing\u2019s syndrome: A systematic review","volume":"98","author":"Ritzel","year":"2013","journal-title":"J. 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Metab."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1373\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:41:57Z","timestamp":1784266917000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071373"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071373","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}