Abstract：
:Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 patients operated on during the last 15 years. The causes of hypercortisolism were Cushing's disease (n = 78), ectopic ACTH syndrome (n = 3), and primary adrenocortical nodular dysplasia (Carney-Meador syndrome) (n = 1). Before operation 37% of the patients had severe symptoms of hypercortisolism. A bilateral posterior approach was undertaken in 58 patients, whereas 18 patients had an anterior transabdominal approach and 6 patients a laparoscopic approach. There were two operative deaths (2.4%). Postoperative complications occurred mostly in cases of advanced disease and were observed in 14 patients (17%), among whom 4 had severe complications. At long-term follow-up, one recurrence of hypercortisolism and 12 Nelson syndromes (15%) were observed. In conclusion, bilateral adrenalectomy carries an acceptable operative risk, and we recommend bilateral adrenalectomy rather than long-term suppressive therapy in patients requiring prompt and definitive control of their hypercortisolism or after pituitary surgery failure.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Chapuis Y,Pitre J,Conti F,Abboud B,Pras-Jude N,Luton JPdoi
10.1007/s002689900118subject
Has Abstractpub_date
1996-09-01 00:00:00pages
775-9; discussion 779-80issue
7eissn
0364-2313issn
1432-2323journal_volume
20pub_type
杂志文章abstract：BACKGROUND:Surgical care is critical to establish effective healthcare systems in low- and middle-income countries, yet the unmet need for surgical conditions is as high as 65% in Ugandan children. Financial burden and geographical distance are common barriers to help-seeking in adult populations and are unmeasured in ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4691-x
更新日期：2018-11-01 00:00:00
abstract：:This study was designed to investigate the optimal dose of garlic during long-term feeding and its preventive and therapeutic effects on colon cancer in rats induced by 1,2-dimethylhydrazine (DMH). A total of 240 male Sprague-Dawley rats were grouped and fed with either a basal or a garlic diet of different concentrat...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00294738
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:The aim of this study was to compare the perioperative outcomes when using a micropuncture access set (MS) to those when using a conventional puncture set (CS) for implantation of totally implantable venous access device (TAVID). METHODS:A total of 314 patients undergoing chemotherapy for colorectal cancer ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05336-w
更新日期：2020-04-01 00:00:00
abstract：:The effect of a treatment versus controls may be expressed in relative or absolute terms. For rational decision-making, absolute measures are more meaningful. The number needed to treat, the reciprocal of the absolute risk reduction, is a powerful estimate of the effect of a treatment. It is particularly useful becaus...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-7916-8
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:A substantial number of people are suffering from gastroesophageal reflux disease (GERD). The indication for surgical treatment is the failure of medical treatment in patients with objectively verified GERD. The use of PPIs has been noted to increase with the length of follow-up after fundoplication, raising...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-3924-8
更新日期：2017-08-01 00:00:00
abstract：:Extracorporeal life support has evolved considerably over the past two decades. Once considered as salvage or experimental therapy in adults, extracorporeal membrane oxygenation (ECMO) is evolving into a mainstream treatment for adult critical care. This is especially true in trauma and high-risk surgical patients, wh...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-016-3586-y
更新日期：2017-05-01 00:00:00
abstract：:Although HLA matching can improve organ graft survival, well matched grafts fail and poorly matched ones survive. Recently evidence has been found that perinatal exposure to noninherited antigens (NIMAs) has a lifelong impact on the immune repertoire of the individual. The state of the art of the influence of NIMAs on...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680010132
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:It is now generally believed that regulatory T cells (Tregs) play an important role in peripheral tolerance, and a defect in Tregs is considered one of the most important factors in the induction of various kinds of autoimmune disease including ulcerative colitis (UC). Here, we examined the change in frequen...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0301-9
更新日期：2006-04-01 00:00:00
abstract：BACKGROUND:Esophageal achalasia is characterized by the absence of esophageal peristalsis and by a dysfunctional lower esophageal sphincter (LES). Descriptions of clinical, radiological, and manometric findings in patients with achalasia usually have been based on small numbers of patients. This study was designed to d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9656-z
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Recurrent spontaneous pneumothorax is widely treated by video-assisted thoracoscopic (VATS) bullectomy and pleurodesis. Treatment of postoperative pain with nonsteroidal antiinflammatory drugs (NSAIDs) is controversial as many surgeons believe that it reduces the efficacy of pleurodesis and increases the pne...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1207-3
更新日期：2011-11-01 00:00:00
abstract：:This article surveys in an interdisciplinary fashion the evolution of ancient Greek medicine and traumatology in particular. In sounding out the key methods and themes of Greek medicine, we cite a range of medical treatises and correlate them to the rich evidence of ancient Greek art (iconography), which often is expl...
journal_title：World journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1007/s00268-003-6931-x
更新日期：2004-04-01 00:00:00
abstract：:The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0239-5
更新日期：2002-04-01 00:00:00
abstract：:This study investigated whether cytokines and colony-stimulating factors can predict prognosis in patients with postoperative multiple organ failure (MOF). We evaluated 14 patients with postoperative MOF who underwent operation for cardiovascular disease. Seven patients recovered from MOF (survivors) and seven did not...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900520
更新日期：1998-10-01 00:00:00
abstract：:Percutaneous dilatational tracheostomy (PDT) is being increasingly used. Concerns have been raised as to its safety, especially when it is done at the bedside. A prospective evaluation was conducted of 100 consecutive, unselected critically ill patients with PDT. The mean intensive care unit (ICU) stay before PDT was ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680010180
更新日期：2000-09-01 00:00:00
abstract：:The introduction of laparoscopic techniques for the management of biliary stone disease has expanded the therapeutic choices for surgeons confronted with choledocholithiasis. As new strategies emerge, the treatment of cholelithiasis and choledocholithiasis remains controversial. This paper discusses the options availa...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900531
更新日期：1998-11-01 00:00:00
abstract：:There is debate regarding use of the stereotactic core-needle biopsy (SCNB) for highly suspicious mammographic lesions. This study compares a serial group of mammography-detected breast cancer patients treated before and after the use of SCNB. We studied 113 consecutive nonpalpable breast cancers between 1994 and 1996...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900510
更新日期：1998-10-01 00:00:00
abstract：:During the period 1979 to 1989, 0.1% of all cases of acute appendicitis at our institution occurred soon after another operative procedure. The interval between primary operation and appendectomy was 5 to 31 days (mean, 14 days). Signs and symptoms did not differ from those of classical acute appendicitis. Duration of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01675654
更新日期：1991-07-01 00:00:00
abstract：BACKGROUND:Total mesorectal excision (TME) and preoperative chemoradiation therapy (PCRT) for rectal cancer are used sequentially in our center. The aim of this study was to evaluate survival of patients with stage II/III rectal cancer chronologically and to determine whether therapeutic advances associated with TME an...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2168-5
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Medullary thyroid cancer (MTC) represents the third most common type of thyroid cancer, and the prognosis depends on the stage of the disease at diagnosis and completeness of tumor resection. In 2009, the American Thyroid Association (ATA) published guidelines with evidence-based recommendations for the trea...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3643-6
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Frequent use of computed tomography (CT) in trauma patients results in frequent detection of non-trauma-related incidental findings (IFs). Inpatient documentation and disclosure at discharge are infrequent, even when they are potentially serious. We aimed to not only identify the incidence of IFs but also to...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2092-8
更新日期：2013-09-01 00:00:00
abstract：:Cost-benefit and cost-effectiveness analyses (CEAs) are only now beginning to be used by business, government, and policymakers to evaluate various medical treatments. The evolution of why CEAs are being demanded is reviewed. To date, a formal CEA of obesity treatments has not been published. This article outlines how...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900508
更新日期：1998-09-01 00:00:00
abstract：:Mesosigmoidoplasty is a nonresective procedure for nongangrenous sigmoid volvulus. It aims to correct the main pathogenetic factor of this condition, the narrow but long mesosigmoid. Although it had been demonstrated by intraoperative measurements that this has indeed achieved its purpose, recurrent volvulus has been ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7010-z
更新日期：2003-12-01 00:00:00
abstract：:There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900016
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:The aim of this study was to investigate the factors for considering surgery on thyroid nodules that had non-diagnostic results on two consecutive cytology examinations. METHODS:A total of 104 thyroid nodules with two consecutive non-diagnostic cytology examinations in 104 patients were investigated. Nodule...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1397-8
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:The World Health Organization has a standardized tool to assess surgical capacity in low- and middle-income countries (LMICs), but it is often resource- and time-intensive. There currently exists no simple, evidence-based measure of surgical capacity in these settings. The proportion of cesarean deliveries i...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1794-7
更新日期：2013-07-01 00:00:00
abstract：:Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7040-6
更新日期：2004-01-01 00:00:00
abstract：:The expression of Fas ligand on tumor cells may counterattack the host's immunity and worsen the prognosis. Knowledge of the prognostic impact of Fas ligand on patients with hepatocellular carcinoma (HCC) after hepatectomy is still limited. Fas ligand expression in HCCs was examined in 59 patients who underwent hepate...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7254-2
更新日期：2004-08-01 00:00:00
abstract：:In 1990 Scopinaro's technique of biliopancreatic diversion with distal gastrectomy (DG) and gastroileostomy was modified. A sleeve gastrectomy with duodenal switch (DS) was used instead of the distal gastrectomy; and the length of the common channel was made 100 cm instead of 50 cm. A questionnaire and a prescription ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900498
更新日期：1998-09-01 00:00:00
abstract：:Papillary thyroid carcinoma is a frequent thyroid cancer. Many factors have been reported to be of prognostic importance, but the significance of biologic factors suggesting aggressiveness and proliferating activity has not been sufficiently documented. Conventional prognostic factors such as age, extrathyroidal invas...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900551
更新日期：1998-12-01 00:00:00
abstract：:Congenital diaphragmatic hernia (CDH) is one of the most common causes of neonatal morbidity and mortality. The clinical spectrum of CDH ranges from minimally affected infants who do well with modern neonatal care to severely affected infants who die despite all interventions. Two decades of research have led to advan...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-002-6739-0
更新日期：2003-01-01 00:00:00
