Surgical and functional outcomes of adrenalectomy by urologists: A 17-year cohort review

Incidental adrenal masses are found in up to 7% of all patients undergoing abdominal imaging. Data from the American College of Surgeons National Surgical Quality Improvement Program suggests that over 95% adrenalectomies are performed by general surgeons. To assess outcomes when surgeries are performed by urologists, we reviewed our database of adrenalectomies performed in the past 17 years.

In this study, we reviewed our database of patients who underwent adrenalectomies between 2008 and 2024 in the department of urology. Clinical parameters were recorded for all patients, including their demographic profile, metabolic and radiological parameters, operative details, and complications. Outcomes were reported, and data for minimally invasive surgery were compared with those for open surgery (OS).

During the study period, 320 patients underwent 383 adrenalectomies, including 275 patients (85.9%) who had functional tumors, 69% of which were pheochromocytomas, 15.6% Cushing's syndrome, and 11.2% Conn's syndrome. Sixty-three patients had bilateral surgeries. Over 80% (260) patients had laparoscopic surgeries, and an additional 12 were robot-assisted. Six were converted to OS. The mean operative time (122.1 ± 58.3 min vs. 194.1 ± 76.4 min), median blood loss (100 mL vs. 350 mL), and median duration of hospital stay (3 vs. 5 days) were shorter for the minimally invasive approach. The overall complication rate was 6.5%.

Adrenalectomy, including bilateral synchronous surgery, is a safe procedure that can be performed by urologists with excellent outcomes.