Comparing Complications, Functional And Oncological Outcomes Of Partial Versus Total Adrenalectomy: A Systematic...

Area of Science:

• Endocrinology
• Surgical Oncology
• Adrenal Gland Disorders

Background:

• Surgical management is crucial for adrenal masses, especially functional or large ones.
• The choice between partial adrenalectomy (PA) and total adrenalectomy (TA) is debated.
• This study compares surgical outcomes of PA versus TA.

Purpose of the Study:

• To systematically review and meta-analyze surgical outcomes comparing PA and TA.
• To evaluate differences in recurrence, metastasis, mortality, and functional preservation.
• To assess perioperative complications and other surgical parameters.

Main Methods:

• Systematic literature search following PRISMA 2020 guidelines (PubMed, Scopus, Web of Science, Cochrane).
• Inclusion of 19 studies with 3,165 patients (1,084 PA, 2,081 TA).
• Random-effects meta-analysis to pool outcomes; quality assessed by NOS.

Main Results:

• PA showed higher recurrence risk (RR=2.64) but reduced steroid dependence (RR=0.44) and adrenal insufficiency (RR=0.49).
• PA had fewer mild perioperative complications (RR=0.56) but no difference in severe complications, metastasis, or mortality.
• Higher recurrence in PA for pheochromocytoma vs. Conn's adenoma; PA had fewer complications in Conn's patients.

Conclusions:

• PA preserves adrenal function and reduces mild complications but increases recurrence risk in pheochromocytoma patients.
• PA is not associated with increased recurrence in Conn's patients.
• Individualized surgical approach based on tumor type and patient factors is essential.