Delaney J P, Solomkin J S, Jacobson M E, Doe R P
Surgery. 1978 Oct;84(4):465-70.
Twenty-seven operations for Cushing's syndrome were reviewed. Included were five cases of adenoma and 22 of adrenal cortical hyperplasia. Preoperative laboratory data, particularly the metyrapone test, were highly accurate in distinguishing adenoma from hyperplasia. Bilateral flank incisions are preferable to the transabdominal approach, with fewer complications, less postoperative ileus, and shorter hospital stays. The inability to inspect both glands simultaneously is of little consequence because biochemical testing data are sufficiently accurate to obviate the need for gross evaluation. The use of perioperative prophylaxis seems to be of importance for preventing thromboembolism in these hypercoagulable patients. The preoperative use of adrenal cortical blocking agents has not proved to yield significant advantages.
对27例库欣综合征手术进行了回顾。其中包括5例腺瘤和22例肾上腺皮质增生。术前实验室检查数据，尤其是甲吡酮试验，在区分腺瘤和增生方面具有很高的准确性。双侧胁腹切口比经腹入路更可取，并发症更少，术后肠梗阻更少，住院时间更短。无法同时检查双侧腺体影响不大，因为生化检测数据足够准确，无需进行大体评估。围手术期预防用药对于预防这些高凝患者的血栓栓塞似乎很重要。术前使用肾上腺皮质阻断剂尚未证明有显著优势。
