Surgical failure or recurrence of Cushing’s disease can be treated with medical therapy, radiotherapy, adrenalectomy, and/or repeat transsphenoidal surgery, all of which have their respective benefits and drawbacks. Redo transsphenoidal surgery has been shown to achieve at least short-term remission in about 40–80% of patients and is associated with low rates of morbidity and near-zero mortality, albeit higher rates of postoperative hypopituitarism, diabetes insipidus, and cerebrospinal fluid leak than initial resection. Despite this, recurrence may ensue in 50% of patients. When selecting patient candidates for reoperation, many predictors of postoperative outcomes have been proposed including imaging characteristics, histopathological staining, intraoperative tumor visualization, and tumor size, however no single predictor consistently predicts outcomes. Redo transsphenoidal surgery should be performed by an experienced pituitary surgeon and patients should be followed at a tertiary care center by a multidisciplinary team consisting of an experienced endocrinologist and neurosurgeon to monitor closely for remission and recurrence.

库欣病的手术失败或复发可以通过药物治疗、放疗、肾上腺切除术和/或重复经蝶手术治疗，所有这些都有其各自的优点和缺点。重做经蝶窦手术已被证明可在约 40-80% 的患者中实现至少短期缓解，并且与较低的发病率和接近零的死亡率相关，尽管术后垂体功能减退、尿崩症和脑脊液漏的发生率较高比初始切除。尽管如此，仍有 50% 的患者会复发。在选择再次手术的患者候选者时，已经提出了许多术后结果的预测因素，包括影像学特征、组织病理学染色、术中肿瘤可视化和肿瘤大小，然而，没有一个单一的预测因素能够始终如一地预测结果。重做经蝶窦手术应由经验丰富的垂体外科医生进行，患者应在三级医疗中心由经验丰富的内分泌学家和神经外科医生组成的多学科团队进行随访，以密切监测缓解和复发情况。