The retroperitoneal approach provides direct access to adrenal glands, and the performance of bilateral adrenalectomy
is feasible without repositioning the patients when posterior retroperitoneal approach is selected.
In this series in 2 patients the source of ACTH could not be removed and the patients required bilateral adrenalectomy
, as we lack pharmacological agents that are able to safely reduce cortisol burden.
Animals submitted to bilateral adrenalectomy
received a 0.
Although radiation therapy to the lymph nodes resulted in palliation of symptoms, 6 years later a bilateral adrenalectomy
with adrenal hormone replacement was undertaken as definitive therapy for recurrent symptoms.
Standard therapy for clinical AIMAH is bilateral adrenalectomy
, which can remove the source of serum cortisol radically, with 5-year survival rates being 66% to 70%.
In the mid 20th century bilateral adrenalectomy
was used to reduce postmenopausal estrogens but this major operation was replaced by use of the adrenal steroid hormone synthesis inhibitor, aminoglutethimide, although corticosteroid replacement had to be used.