[Intraoperative ultrasonography in Itsenko-Cushing's disease and syndrome]

Ultrasonic study conducted during an operation is finding wider use lately. Surgery is the main method of treatment of most diseases of the adrenals, therefore problems of topical intraoperative diagnosis are very urgent. Twenty-three patients were operated on for Itsenko-Cushing's disease and syndrome and tumors of the retroperitoneal space at the Faculty Surgical Clinic of the Moscow Medical Academy within a period of 12 months. All patients were subjected to complex ultrasonic examination, including pre-intra- and postoperative study. Intraoperative ultrasonic study was conducted in two stages: stage 1--examination after thoracotomy through the diaphragm for choosing the optimal place and length of phrenotomy; stage 2--ultrasonic examination after phrenotomy to localize precisely the adrenal or tumor and reveal their connection with the adjacent organs and vascular structures. Complex ultrasonic examination has advantages over the other examination methods (computed tomography, angiography, scintigraphy) which allows it to come to the forefront in the diagnostic search for adrenal tumors. Intraoperative ultrasonic examination makes it possible for the surgeon to avoid wide phrenotomy and prolonged investigation, reduces the possibility of inflicting injury to the large vessels, which reduces the duration of the operation and anesthesia, and improves the course of the postoperative period.