Adrenal

Adrenal Surgery

2000 – 2017

The management of patients with bilateral adrenal tumors can be challenging. Cleveland Clinic surgeons have created surgical algorithms for efficient treatment of bilateral masses, with 95% of surgeries performed using minimally invasive procedures.

Surgical Approach and Morbidity Following Bilateral Adrenal Tumors

N = 44

Bilateral Adrenalectomy Patient Information and Outcomes

N = 44

Laparoscopic Robotic-Assisted Open
N 27 15 2
Age, years, mean 53.3 51.1 60
Sex, N
Female 20 11 2
Male 7 4 0
Diagnosis, N
Cushing 24 10 0
Pheochromocytoma 2 5 1
Metastasis 1 0 1
Approach, N
Lateral 6 7 NA
Posterior 21 8 NA
Operative time, minutes, mean 296 393 294
Estimated blood loss, mL, mean 85.6 66.9 1000
Length of stay, days, mean 4.4 2.5 8.5
30-day complications, N
Morbidity 7 5 1
Mortality 0 0 0
Bilateral Adrenalectomy Comparing Lateral Transabdominal Approach to Posterior Retroperitoneal Approach

N = 42

Lateral Posterior
N 13 29
Age, years, mean 48.7 54.2
Sex, N
Female 10 21
Male 3 8
ASA, median 3 3
Body mass index, kg/m2, mean 37.3 29.7
Diagnosis, N
Cushing 10 24
Pheochromocytoma 3 4
Metastasis 0 1
Operative time, minutes, mean 377 311
Estimated blood loss, mL, mean 78.4 79.0
Length of stay, days, mean 3 3.8
30-day complications, N
Morbidity 5 7
Mortality 0 0

ASA = American Society of Anesthesiologists (American Society of Anesthesiologists Physical Status Classification System)