Quality of life after laparoscopic bilateral adrenalectomy for Cushing's disease

Background. Bilateral adrenalectomy to control symptoms of Cushing's disease after failed transsphenoidal operation is effective. We examined surgical outcomes and quality of life after laparoscopic bilateral adrenalectomy for the treatment of Cushing's disease. Methods. Eighteen patients underwent laparoscopic bilateral adrenalectomy from November 1994 through December 2000. Patient data were obtained from chart reviews. Patients completed a follow-up survey including the SF-36 health survey (QualityMetric Inc, Lincoln, Neb). Results. Laparoscopic bilateral adrenalectomy was accomplished in all 18 patients. There was 1 intraoperative complication of a colotomy, and 2 postoperative complications including 1 pancreatic pseudocyst and 1 hemorrhage. Three patients died at 12, 19, and 50 months after operation. At a median follow-up of 29 months, patients reported improvement in all Cushing's-related symptoms. Nine of 11 patients who responded to the survey stated their heath was improved after adrenalectomy. Results of the SF-36 health survey showed significantly lower scores in all 8 measured parameters when compared with the general population. Conclusions: Results of laparoscopic bilateral adrenalectomy show this procedure is comparable with open adrenalectomy in controlling symptoms of Cushing's disease. Despite patient reported improvement in health after adrenalectomy, this patient population continues to experience poor health as measured by the SF-36 when compared with the general population.