Evaluation Of The Efficacy Of Laparoscopic Total Or Partial Adrenalectomy For The Treatment Of ACTH Non-Dependent Cushing’s Syndrome Caused By Adrenal Tumors

Objective: Exploring the efficacy of laparoscopic total or partial adrenalectomy for the treatment of ACTH non-dependent Cushing’s syndrome caused by adrenal tumors with laparoscopic total or partial adrenalectomy.Methods: The clinical data of patients admitted to the Department of Urology,Shengjing Hospital,China Medical University,with ACTH non-dependent Cushing’s syndrome caused by adrenocortical adenoma and undergoing laparoscopic unilateral adrenal/adrenal tumor resection were retrospectively analyzed.The time span was from January2014 to December 2021.All patients were divided into two groups: complete and partial adrenalectomy on the affected side,based on whether the normal adrenal tissue on the affected side was preserved at the time of surgical resection.The differences in the duration of surgery,intraoperative bleeding,the number of days of drainage tube retention and total drainage,and the number of days of hospitalization were compared between the two resection methods;patients were also followed up to observe whether their Cushing’s symptoms were relieved,whether their adrenal biochemical parameters returned to normal,and the time to stop hormone replacement therapy after surgery.Results: In terms of operative time,the average operative time in the partial incision group was shorter than that in the total incision group.In terms of intraoperative bleeding,the average amount of bleeding was less in the total-cut group than in the partial-cut group.In terms of drainage volume,the average drainage volume in the total resection group was more than that in the partial resection group.The total excision group may be more prone to postoperative complications than the partial excision group because of the excessive removal of normal adrenal tissue on the affected side.The postoperative Cushing’s symptoms were improved and relieved to varying degrees,with a higher percentage of improvement in the total-cut group.The duration of postoperative hormone replacement therapy was shorter in the partial excision group than in the total excision group.The rest of the indicators did not show statistically significant differences between them.Conclusion: In laparoscopic surgery for patients with ACTH non-dependent Cushing’s syndrome due to adrenocortical adenoma,total resection of one adrenal gland is theoretically complete,but the longer operative time,more postoperative complications,and longer mean time to postoperative hormone replacement therapy in the total resection group than in the partial resection group may affect patient recovery and compliance.Partial resection,on the other hand,has some advantages in some aspects,but care should be taken to remove the tumor cleanly and avoid bleeding during surgery.