副腎手術例の検討

Abstract

The clinical observations on 43 cases of adrenal surgery experienced at our hospital during a 15 year period is reported. There were 14 cases of Cushing's syndrome, 11 cases of primary aldosteronism, 7 cases of pheochromocytoma, 5 cases of neuroblastoma, and 6 miscellaneous cases. Locality and laterality diagnosis was achieved correctly in all the cases seen after 1975 by the combined diagnostic method of adrenal scintigraphy, CT-scan and adrenal vein catheterization. As for surgical approach to the adrenal gland, the anterior subcostal incision provided us superior surgical exposure to the adrenals, bilateral accessibility and less complications than the other approaches. A difference on the postoperative blood pressure reduction pattern was noted according to the adrenal disorders: In contrast to immediate normotension after surgery in pheochromocytoma cases, normotension was achieved one month postoperatively in primary aldosteronism. Blood pressure reduction was the most delayed in Cushing's syndrome.