Our Summary

This research paper is about how to treat adrenal tumors, which are growths on the adrenal glands. If the tumor is larger than 2.0 cm, the usual treatment is to surgically remove it. However, for tumors smaller than 2.0 cm, the paper suggests using imaging techniques to spot the tumor early.

The paper also mentions a drug called phenoxybenzamine, which can be used before surgery to reduce the risk of mortality in patients with a specific type of adrenal tumor known as pheochromocytoma.

The researchers also talk about the best surgical technique to remove the tumor, stating that it can be done either via a minimally invasive laparoscopic method or an open surgery, depending on the tumor’s characteristics and the surgeon’s expertise. They note, however, that if the tumor has spread to the blood vessels, a laparoscopic technique should not be used.

The paper also discusses how to manage cases where the tumor has invaded the blood vessels and when part of the large vein (cava) needs to be removed.

FAQs

  1. What is the standard of care for adrenal tumors greater than 2.0 cm in diameter?
  2. What is the role of phenoxybenzamine in the treatment of pheochromocytoma before surgery?
  3. When is laparoscopic technique not recommended for adrenalectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about adrenalectomy is to make sure to follow all pre-operative instructions provided by the medical team, such as fasting before surgery and taking any prescribed medications as directed. It is also important to discuss any concerns or questions with the healthcare provider before the procedure. After surgery, it is crucial to follow post-operative care instructions, such as taking pain medication as prescribed, monitoring for any signs of infection, and attending follow-up appointments to ensure proper healing.

Suitable For

Patients who are typically recommended adrenalectomy include those with adrenal tumors greater than 2.0 cm in diameter, adrenal malignancies, and pheochromocytoma. Additionally, patients with adrenal tumors smaller than 2.0 cm may also be recommended for adrenalectomy if imaging techniques suggest the presence of malignancy. Pretreatment with phenoxybenzamine may be recommended for patients with pheochromocytoma to reduce surgical mortality risk. The choice between laparoscopic or open surgical techniques depends on tumor anatomy and surgeon experience, with vascular invasion being a contraindication for laparoscopic surgery. This review provides information on minimally invasive and open adrenalectomy techniques, as well as management of vascular invasion and partial cavectomy.

Timeline

Before adrenalectomy:

  • Patient undergoes imaging tests to diagnose adrenal tumor
  • Patient may undergo hormone tests to assess adrenal function
  • Patient may be prescribed medication, such as phenoxybenzamine, to manage symptoms of pheochromocytoma
  • Surgical team evaluates the size and location of the tumor to determine the best approach for surgery

After adrenalectomy:

  • Patient is monitored closely for complications, such as bleeding or infection
  • Patient may experience pain and discomfort at the surgical site
  • Patient may need to take hormone replacement therapy if the adrenal gland was removed
  • Patient may need to follow up with their healthcare provider for ongoing monitoring and care.

What to Ask Your Doctor

  1. What is the reason for recommending an adrenalectomy in my case?
  2. Are there any alternative treatments or therapies that I should consider before undergoing surgery?
  3. What are the risks and potential complications associated with adrenalectomy?
  4. How long is the recovery period after adrenalectomy and what can I expect during the recovery process?
  5. Will I need to take any medications or make lifestyle changes after the surgery?
  6. How often will I need to follow up with you after the surgery?
  7. Are there any specific dietary or activity restrictions I should be aware of post-surgery?
  8. How will my adrenal function be affected after the surgery and will I need any additional testing or monitoring?
  9. What is your experience with performing adrenalectomy procedures and what is your success rate?
  10. Are there any specific factors in my case that may affect the surgical approach or outcome of the adrenalectomy?

Reference

Authors: Hayes G. Journal: Vet Clin North Am Small Anim Pract. 2022 Mar;52(2):473-487. doi: 10.1016/j.cvsm.2021.12.005. PMID: 35210060