Retrospective Review of Adrenalectomy in a Tertiary Center in Nepal

  • Pawan Dhital
  • Bipendra DK Rai
  • Manish Pradhan
  • Sujeet Poudyal
  • Suman Chapagain
  • Bhoj R Luitel
  • Pawan R Chalise
  • Uttam K Sharma
  • Prem R Gyawali

Abstract

Introduction
Adrenal gland surgery is a challenging art as it encompasses diverse physiological derangements which are even
life-threatening. Also, it remains a medical finesse to rightly identify the correct patient who will benefit from
surgery which include strong biochemical and radiological resource. Soundly performed surgery will lead to
oncologic and homeostatic correction leading to near normal course.
Methods
This is a retrospective analysis of adrenalectomy cohort over three years in a tertiary center in Nepal identifying
diagnosis, perioperative management and postoperative course. The objective of this study is to review the
presentation, histopathology and clinical outcomes of patients operated for adrenal mass in our center.
Results
There were 42 surgeries performed via open approach. The number of adenoma, phaeochromocytoma, carcinoma
and non-functioning tumor were 13, 16, 12 and one respectively. In most of the hypertensive patients, control
was achieved with minimal drug and recurrences were observed in 25% of carcinoma in postoperative follow up.
Conclusion
A large proportion of operative adrenal mass are observed clinically in our setup. The surgical outcome is
satisfactory but judicious perioperative management is essential.
Keywords
Adrenalectomy, adrenocortical carcinoma, phaeochromocytoma

Published
2019-08-26