Outcome of Adrenalectomy at a tertiary centre

Abstract

Introduction and objectives: To review the profile of patients with adrenal pathology, and evaluate the              outcome and complications of adrenalectomies performed in our department over a 7-year period. Materials and methods: We retrospectively reviewed the records from the hospital’s electronic database from January 2008 to April 2015. Data of all the patients who                   underwent adrenalectomy for various pathologies were studied. Demographic characteristics, operative                  techniques, operative time and estimated blood loss, outcome and follow up were evaluated. Results: A total 70 patients underwent adrenalectomy over a 7-year             period for various pathologies. The diagnoses included pheochromocytoma (18), myelolipoma (29),                 adrenocortical carcinoma (5), adenoma (3-non-functional, 6 functional), cyst (2) and ganglioneuroma (3). Histologic surprises included single cases of PNET, scwanoma, histoplasmosis and extramedullary hemopoisis (one case each). Male and female ratio was 39/32. Mean age was 43.4 years (SD 15.7). Forty-eight (67%) underwent right, while 2 had bilateral adrenalectomy. Approach was laparoscopic in 27 (38%) of which two required open conversion and rest had open surgery. Mean size of tumours undergoing laparoscopy was significantly smaller than those in open (6.3 vs 9.2 cm, p=0.025). Mean operative time in laparoscopic and open groups was 156.2 min and 217 min (p=0.302) and estimated blood loss was 175 ml and 655 ml (p= 0.083)                   respectively. Intraoperative complications included bleeding necessitating transfusion-7, pleural injury-4, liver laceration-3.