Our Summary

This study looked at the relationship between the number of surgeries a surgeon performs, the type of surgery they use, and the amount of resources used for operations involving the adrenal glands. The researchers defined ‘high-volume’ surgeons as those who perform six or more of these surgeries per year.

They found that high-volume surgeons performed the majority of these surgeries and more often operated on a type of tumor called pheochromocytoma. They were also less likely to operate on cancers that had spread to the adrenal glands. High-volume surgeons were also more likely to use a less invasive type of surgery called laparoscopy, and their surgical supplies cost less on average.

Furthermore, this less invasive surgery was linked to shorter hospital stays, lower hospitalization costs, and patients were more likely to go straight home after surgery. This suggests that surgeons who perform more of these operations are more likely to use this less invasive method, which in turn uses fewer healthcare resources.

FAQs

  1. How did the study define ‘high-volume’ surgeons?
  2. What type of tumor did high-volume surgeons more often operate on?
  3. What were the benefits of using a less invasive surgery method like laparoscopy in terms of hospital stays and costs?

Doctor’s Tip

Therefore, if you are considering an adrenalectomy, it may be beneficial to seek out a high-volume surgeon who has experience with these types of surgeries. Not only are they more likely to use less invasive techniques, but they may also be able to provide a better overall outcome and lower healthcare costs for you. It is important to discuss with your doctor the benefits and risks of surgery, as well as the experience and expertise of the surgeon who will be performing the procedure.

Suitable For

Patients who are typically recommended for adrenalectomy include those with adrenal tumors (such as adrenal adenomas, pheochromocytomas, adrenal cortical carcinomas), adrenal hyperplasia, and adrenal metastases (cancers that have spread to the adrenal glands). Adrenalectomy may also be recommended for patients with hormone-producing tumors that are causing symptoms such as high blood pressure, excessive sweating, or unexplained weight gain.

In general, patients who are young and healthy enough to undergo surgery, and whose tumors are causing symptoms or are suspicious for cancer, are considered good candidates for adrenalectomy. The decision to undergo adrenalectomy should be made in consultation with a surgeon and an endocrinologist, who can evaluate the risks and benefits of surgery based on each individual patient’s specific situation.

Timeline

Before adrenalectomy:

  1. Patient experiences symptoms such as high blood pressure, sweating, headaches, and unexplained weight loss.
  2. Patient undergoes diagnostic tests such as blood tests, imaging scans, and hormone level tests to confirm the presence of an adrenal tumor.
  3. Patient consults with a surgeon to discuss the possibility of adrenalectomy and the risks and benefits of the surgery.
  4. Surgery is scheduled and patient undergoes pre-operative evaluations and preparations.

After adrenalectomy:

  1. Patient undergoes the surgical procedure to remove the adrenal tumor.
  2. Depending on the type of surgery used (laparoscopy or open surgery), patient may experience less pain and have a shorter hospital stay with laparoscopy.
  3. Patient is monitored closely for any complications such as bleeding, infection, or adrenal insufficiency.
  4. Patient may need hormone replacement therapy if the remaining adrenal gland is not functioning properly.
  5. Patient undergoes follow-up appointments to monitor recovery and assess for any recurrence of the tumor.

What to Ask Your Doctor

  1. How many adrenalectomies do you perform each year?
  2. What type of adrenalectomy do you recommend for my specific condition?
  3. What are the potential risks and complications of adrenalectomy?
  4. What is the typical recovery time after adrenalectomy?
  5. Will I need any additional treatments or medications after the surgery?
  6. What is your experience and success rate with adrenalectomy procedures?
  7. Are there any alternative treatments to adrenalectomy that I should consider?
  8. How will my adrenal function be affected after the surgery?
  9. Will I need any follow-up appointments or tests after the surgery?
  10. How will adrenalectomy impact my overall health and well-being in the long term?

Reference

Authors: Ginzberg SP, Gasior JA, Kelz LR, Passman JE, Soegaard Ballester JM, Roses RE, Fraker DL, Wachtel H. Journal: Am J Surg. 2024 Mar;229:44-49. doi: 10.1016/j.amjsurg.2023.10.042. Epub 2023 Oct 23. PMID: 37940441