Watanabe H
Nihon Naibunpi Gakkai Zasshi. 1980;56(12):1662-78. doi: 10.1507/endocrine1927.56.12_1662.
Adrenal surgery was performed on 162 cases of various diseases, including 67 primary aldosteronism (PA), 22 adrenal Cushing's syndrome (ACS), 19 hypophyseal Cushing's syndrome (HCS) and 32 pheochromocytoma (Pheo), at Tohoku University School of Medicine from December 1956 to March 1976. The diagnosis, treatments and prognosis of these cases were surveyed. The diagnostic accuracy of pneumoretroperitoneum with tomography was 63% in PA, 95% in ACS and 93% in Pheo, while that of adrenal scintigraphy was 86% in PA and 100% in ACS. Scintigraphy and aldosterone assay in venous blood samples the most reliable for the localization of PA. The unilateral approach was the most suitable procedure for the removal of adrenal tumors in PA, ACS and single Pheo within a few hundred grams. The anterior approach was preferable for single Pheo over a few hundred grams and bilateral or multiple Pheo. As regards the treatment for HCS, good results were obtained by a combination therapy of bilateral subtotal adrenalectomy, hypophyseal radiation and reserpine administration. Two cases of Pheo were inoperable. There were 3 deaths immediately after the removal of Pheo. We later investigated the blood pressure in successfully treated cases. Hypertension was noticed in 18% of PA and 10% of ACS. No hypertensive case was found in Pheo.
1956年12月至1976年3月期间，东北大学医学院对162例患有各种疾病的患者进行了肾上腺手术，其中包括67例原发性醛固酮增多症（PA）、22例肾上腺皮质醇增多症（ACS）、19例垂体性皮质醇增多症（HCS）和32例嗜铬细胞瘤（Pheo）。对这些病例的诊断、治疗和预后进行了调查。断层气腹造影对PA的诊断准确率为63%，对ACS的诊断准确率为95%，对Pheo的诊断准确率为93%，而肾上腺闪烁扫描对PA的诊断准确率为86%，对ACS的诊断准确率为100%。静脉血样的闪烁扫描和醛固酮测定对PA的定位最可靠。单侧入路是切除PA、ACS和几百克以内的单发Pheo肾上腺肿瘤的最合适方法。对于几百克以上的单发Pheo以及双侧或多发Pheo，前路入路更为可取。对于HCS的治疗，通过双侧肾上腺次全切除术、垂体放疗和利血平给药的联合治疗取得了良好效果。2例Pheo无法手术切除。切除Pheo后立即有3例死亡。我们后来对成功治疗的病例进行了血压调查。发现PA患者中有18%、ACS患者中有10%出现高血压。在Pheo患者中未发现高血压病例。
