Our Summary

This research paper is about the effectiveness of a surgical procedure called laparoscopic adrenalectomy, which is a minimally invasive surgery to remove the adrenal glands. The study looked at 62 patients who had this procedure done due to their adrenal glands being affected by cancer that had spread (metastasized) from other parts of their body.

Most of the surgeries (95%) were done laparoscopically, which means a small camera and instruments were used, allowing for smaller cuts and quicker recovery. The primary cancers that had spread to adrenal glands were non-small cell lung cancer, kidney cancer, and melanoma (a type of skin cancer).

The research found that there were no deaths within 30 days of the surgery, and only a few complications. The median survival time after the surgery was 34 months, with patients’ survival times varying depending on the type of cancer they had. The study also found that there was no difference in survival times between patients whose cancer had spread at the same time as their original diagnosis and those whose cancer spread later.

The survival times were not linked to the size of the adrenal gland tumor or whether the patient had other metastases (cancer spread to other parts of the body). The research concluded that laparoscopic adrenalectomy is a safe procedure when done by experienced surgeons, and it seems to give similar or even better results than traditional open surgery.

In fact, the patients who had this minimally invasive surgery to remove cancerous adrenal glands lived longer than similar patients who did not have the surgery, according to a large cancer database.

FAQs

  1. What is a laparoscopic adrenalectomy and why is it performed?
  2. What were the main findings of the research regarding survival times after laparoscopic adrenalectomy?
  3. How does the safety and effectiveness of laparoscopic adrenalectomy compare to traditional open surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and avoiding strenuous activities until cleared by the surgeon. It is also important to maintain a healthy lifestyle, including a balanced diet and regular exercise, to support recovery and overall well-being.

Suitable For

Patients who are typically recommended for adrenalectomy include those with:

  1. Adrenal tumors that are causing symptoms such as high blood pressure, hormone imbalances, or pain
  2. Adrenal tumors that are suspected or confirmed to be cancerous
  3. Adrenal tumors that are larger in size or growing
  4. Adrenal tumors that are causing compression or displacement of nearby organs
  5. Patients with primary adrenal cancer or cancers that have spread to the adrenal glands from other parts of the body
  6. Patients with hormone-producing tumors such as pheochromocytoma, aldosteronoma, or Cushing’s syndrome

It is important for patients to consult with their healthcare provider to determine if adrenalectomy is the best treatment option for their specific condition.

Timeline

  • Before adrenalectomy:
  1. Patient is diagnosed with cancer that has spread to the adrenal glands.
  2. Patient undergoes pre-operative evaluations and tests to determine if they are a candidate for adrenalectomy.
  3. Surgery is scheduled and patient receives instructions on pre-operative care and preparation.
  • After adrenalectomy:
  1. Surgery is performed, either laparoscopically or through traditional open surgery.
  2. Patient is monitored in the hospital for any complications or side effects.
  3. Patient is discharged from the hospital and given instructions for post-operative care.
  4. Patient may experience pain, fatigue, and limited mobility in the days following surgery.
  5. Follow-up appointments are scheduled to monitor recovery and assess the effectiveness of the surgery.
  6. Patient may undergo further treatment such as chemotherapy or radiation therapy if necessary.
  7. Patient’s survival time and overall health are monitored in the months and years following surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adrenalectomy include:

  1. What are the potential risks and complications associated with adrenalectomy?
  2. How experienced are you in performing laparoscopic adrenalectomy?
  3. How long is the recovery time after the surgery?
  4. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  5. How often will I need follow-up appointments or tests to monitor my condition?
  6. What is the success rate of this surgery in treating adrenal cancer that has spread from other parts of the body?
  7. Are there any specific lifestyle changes or precautions I should take after the surgery?
  8. Are there any long-term effects or risks associated with living without adrenal glands?
  9. How will this surgery affect my hormone levels and overall health?
  10. Can you provide me with information or resources for support groups or organizations for patients undergoing adrenalectomy?

Reference

Authors: Drake FT, Beninato T, Xiong MX, Shah NV, Kluijfhout WP, Feeney T, Suh I, Gosnell JE, Shen WT, Duh QY. Journal: Surgery. 2019 May;165(5):958-964. doi: 10.1016/j.surg.2018.11.008. Epub 2018 Dec 24. PMID: 30591377