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Adrenal surgery 

Adrenal surgery
Adrenal surgery

Sabapathy P. Balasubramanian

and Barney J. Harrison

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date: 27 January 2022

The indications for adrenal surgery and techniques employed have evolved significantly in the last 20 years. The need for adrenalectomy has increased due to:

increased use of abdominal CT/MRI that identifies adrenal incidentalomas

the more frequent biochemical diagnosis of subclinical hormonal syndromes.

The operative approach has changed with the availability of minimal access surgery; this has significant advantages for the patient in terms of reduced morbidity and faster recovery (1).

Despite these changes, the fundamental principles of adrenal surgery have remained unchanged:

Biochemical investigations should be performed before localization studies and/or surgical intervention.

Biopsy is rarely indicated in the investigation of adrenal lesions and is confined to confirmation of adrenal metastasis, suspected lymphoma, tuberculosis, or histoplasmosis. It should only be performed after biochemical assessment has excluded phaeochromocytoma.

Close collaboration with colleagues in endocrinology, biochemistry, and radiology is essential for good outcomes.

This chapter will focus on the surgical aspects of treatment. The pathology of adrenal disease, details of biochemical and radiological investigations, and the nonsurgical modalities of treatment are covered elsewhere.

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