Document Detail


Patients with Cushing's syndrome are care-intensive even in the era of laparoscopic adrenalectomy.
MedLine Citation:
PMID:  19385284     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report outcomes from laparoscopic adrenalectomy (LA) comparing patients with Cushing's syndrome with those with other adrenal pathology with respect to length of stay (LOS), overall complications, and financial implications. We conducted a retrospective review of 80 continuous patients (103 glands) undergoing LA. The clinical diagnoses were: hypercortisolism (Cushing' syndrome; n=33), hyperaldosteronism (Conn's syndrome; n=20), phaeochromocytoma (n=16), and neoplasm (others; n=11). Advanced care in the intermediate or intensive care unit was necessary in 27 patients, most frequently in our Cushing's population (16 of 33 [48%]). Six patients sustained major complications, including death in two patients; seven patients sustained minor complications. LOS was longer for patients with Cushing's syndrome (mean, 5.5 vs. 3.3 days; P = 0.024). Financially, patients with Cushing's syndrome had statistically higher total hospital (P = 0.009), advanced care (P = 0.002), and anesthetic costs (P = 0.005). LA in patients with Cushing's syndrome is associated with longer hospitalizations, more frequent major complications, and higher advanced care requirements, especially for patients undergoing bilateral adrenalectomy. Minor complications were infrequent and median LOS was brief regardless of diagnosis. Patients with Cushing's syndrome had higher costs for overall hospital charges, advanced care, and anesthesia.
Authors:
Nicole A Kissane; Juan C Cendan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  75     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  279-83     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / diagnosis,  surgery
Adrenalectomy / methods*
Adult
Aged
Cushing Syndrome / diagnosis,  surgery*
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Hyperaldosteronism / diagnosis,  surgery
Intensive Care / methods*
Laparoscopy / methods*
Length of Stay / trends
Male
Middle Aged
Pheochromocytoma / diagnosis,  surgery
Retrospective Studies
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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