Bilateral Adrenalectomy

Although commonly used in the past for treating patients with CD/CS to control hypercortisolemia, bilateral adrenalectomy is now reserved for patients who did not respond to pituitary surgery and/or radiotherapy as well as medical treatment. Currently, perioperative morbidity is less than 32% and mortality less than 2% (109,125,126). Laparoscopic adrenalectomy led to a further decline in perioperative morbidity (127). Recurrence rates on long-term follow-up are less than 4%. Postoperatively, patients require lifelong glucocorticoid and mineralo-corticoid replacement therapy and evaluation for residual (ectopic) adrenal tissue, as well as the development of Nelson's syndrome.

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