[A survey of 162 cases treated by adrenal surgery (author's transl)]

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.