Synchronous bilateral adrenalectomy by midline incision: A reliable method for treatment of hypercortisolism

Abstract

• Dear Editor,
  We read an article entitled "Synchronous bilateral adrenalectomy by midline incision: A reliable method for treatment of hypercortisolism" by Tabatabaee et al.^[1] with interest. We congratulate the authors for their good surgical outcomes. However, we would like to clarify a few points about simultaneous bilateral laparoscopic adrenalectomy (SBLA) for patients with medically uncontrollable Cushing's syndrome.
  Laparoscopic adrenalectomy (LA) has significantly reduced the morbidity classically associated with open adrenalectomy. It is now the standard treatment of choice for most benign adrenal tumors, including unilateral Cushing's adenoma.^[2] Even though the authors cited the complication rates of 9.5-12% during unilateral or SBLA, their references were from the earlier series.^[1] In fact, those major complications were infrequently encountered in the experiences of ours and others,^[2-5] with  the mean conversion rate of only 0^[4]-4.7%^[3] during SBLA. In contrast, decreased blood loss, less postoperative pain, earlier resumption of oral feeding, and shorter hospital stays were achieved in patients undergoing either unilateral LA or SBLA.^[3-5] We believe SBLA is technically feasible and safe under experienced hands.