Our Summary

This study looked at patients who had surgery to remove their adrenal glands, which are small glands located on top of each kidney. There were two main types of patients studied: those with benign (non-cancerous) non-functional adrenal masses (BNF) and those with functional adrenal masses. The functional adrenal masses are tumors that secrete hormones and can cause health problems. Three types of functional tumors were studied: hyperaldosteronism, hypercortisolism, and pheochromocytoma.

The researchers analyzed data from over 4,000 patients who had this surgery between 2015 and 2020. They were particularly interested in the rate of complications within 30 days of surgery, the death rate within 30 days, the rate of readmission to the hospital within 30 days, and the length of the hospital stay after surgery.

Results showed that patients with hyperaldosteronism had lower rates of complications and shorter hospital stays than those with BNF tumors. On the other hand, patients with hypercortisolism had higher rates of complications, were more likely to be readmitted to the hospital, and had longer hospital stays. Patients with pheochromocytoma also had higher rates of complications.

When the type of surgical approach was considered, there were no significant differences in outcomes between patients with BNF and functional adrenal masses who had open surgery.

In conclusion, the type of adrenal tumor seems to influence the surgical outcomes. Therefore, the reason for the surgery (i.e., the type of tumor) should be taken into account when planning the procedure.

FAQs

  1. What are the different types of adrenal masses that were studied?
  2. Does the type of adrenal tumor influence the surgical outcomes?
  3. Were there any differences in surgical outcomes between patients who had open surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to discuss the potential risks and benefits of the surgery based on the type of adrenal tumor they have. Patients with functional adrenal masses, such as those with hypercortisolism or pheochromocytoma, may have a higher risk of complications and longer hospital stays compared to those with non-functional adrenal masses. It is important for patients to have a thorough understanding of their specific condition and the potential outcomes of surgery in order to make an informed decision about treatment.

Suitable For

Patients with functional adrenal masses, specifically those with hypercortisolism and pheochromocytoma, may be more likely to be recommended for adrenalectomy due to their potential health complications from hormone secretion. Patients with benign non-functional adrenal masses may also be recommended for surgery if the mass is causing symptoms or if there is concern for malignancy.

Overall, the decision to recommend adrenalectomy will be based on the individual patient’s specific situation, including the type of adrenal mass, symptoms, risk factors, and potential benefits of surgery. It is important for patients to discuss their options with their healthcare provider to determine the best course of action for their particular case.

Timeline

Before the adrenalectomy:

  • Patient undergoes diagnostic testing to determine the type of adrenal mass and assess for any hormonal imbalances
  • Patient may experience symptoms related to the adrenal mass, such as high blood pressure, weight gain, fatigue, or hormonal imbalances
  • Surgery is scheduled and patient may undergo preoperative preparation, such as fasting and medication adjustments

After the adrenalectomy:

  • Patient undergoes surgery to remove the adrenal gland(s)
  • Patient is monitored in the recovery room and may stay in the hospital for a few days post-surgery
  • Patient may experience pain at the incision site and be prescribed pain medication
  • Patient may require hormone replacement therapy if the remaining adrenal gland is unable to produce enough hormones
  • Patient follows up with their healthcare provider for monitoring and management of any complications or hormone imbalances

Overall, the timeline of a patient’s experience before and after adrenalectomy involves preoperative preparation, surgery, recovery, and follow-up care to ensure optimal outcomes and management of any complications.

What to Ask Your Doctor

  1. What type of adrenal mass do I have (benign/non-functional or functional)?
  2. What specific hormone is my tumor secreting (aldosterone, cortisol, or adrenaline)?
  3. What are the risks and benefits of undergoing adrenalectomy for my specific type of tumor?
  4. What are the potential complications of the surgery and how likely are they to occur?
  5. What is the expected recovery time after adrenalectomy?
  6. Will I need hormone replacement therapy after surgery?
  7. How will my adrenal function be monitored post-surgery?
  8. What is the success rate of adrenalectomy for my specific type of tumor?
  9. Are there any alternative treatment options available for my condition?
  10. How many adrenalectomy procedures have you performed and what is your experience with my specific type of tumor?

Reference

Authors: Gao TP, Green RL, Kuo LE. Journal: J Surg Res. 2024 Jun;298:201-208. doi: 10.1016/j.jss.2024.03.031. Epub 2024 Apr 15. PMID: 38626717