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
<pre><code>Female<br /></code></pre> 20 11 2
<pre><code>Male<br /></code></pre> 7 4 0
Diagnosis, N
<pre><code>Cushing<br /></code></pre> 24 10 0
<pre><code>Pheochromocytoma<br /></code></pre> 2 5 1
<pre><code>Metastasis<br /></code></pre> 1 0 1
Approach, N
<pre><code>Lateral<br /></code></pre> 6 7 NA
<pre><code>Posterior<br /></code></pre> 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
<pre><code>Morbidity<br /></code></pre> 7 5 1
<pre><code>Mortality<br /></code></pre> 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
<pre><code>Female<br /></code></pre> 10 21
<pre><code>Male<br /></code></pre> 3 8
ASA, median 3 3
Body mass index, kg/m2, mean 37.3 29.7
Diagnosis, N
<pre><code>Cushing<br /></code></pre> 10 24
<pre><code>Pheochromocytoma<br /></code></pre> 3 4
<pre><code>Metastasis<br /></code></pre> 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
<pre><code>Morbidity<br /></code></pre> 5 7
<pre><code>Mortality<br /></code></pre> 0 0

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