Risks of Adrenal Surgery
In the hands of an experienced adrenal surgeon, adrenal surgery is a safe procedure with few complications.
In general, complications are higher in open adrenalectomies than laparoscopic adrenalectomies. In open adrenalectomies, the common complications are lung related. Pneumonia and atelectasis occurs in approximately 6% of open adrenalectomies. As with other surgeries, there is a risk of wound infection, bleeding, and blood clot formation in the veins of the legs. Blood clot formation risk is reduced by wearing stockings that periodically compress the legs, injections of mild blood thinner, and walking frequently after surgery. After any surgery in the abdomen, the intestines "fall asleep" and do not work as they should. This will get better in a few days and improve as time goes on after surgery.
Adrenal insufficiency is a life-threatening condition where the body is not making enough steroids. Patients that get only one of the adrenal glands surgically removed and their other adrenal gland is normal have a low risk of developing adrenal insufficiency. There is an increased risk of adrenal insufficiency in patients with Cushing's Syndrome because the adrenal gland that is normal and left intact is often not working properly from being suppressed for a long period of time due to the adrenal tumor excreting large quantities of hormone. Adrenal insufficiency can also occur if both adrenal glands are removed and the patient is not receiving enough steroids post-operatively. Patients are monitored closely after an adrenalectomy for adrenal insufficiency.
Injury to Surrounding Organs
Rarely, the organs or blood vessels surrounding the adrenal glands will be injured when they are moved during surgery to gain access to the adrenal glands for removal. The left adrenal gland is surrounded by the colon, kidney, pancreas, spleen, stomach and blood vessels. During left-sided surgery, although rare, the spleen is the most commonly damaged organ and may need to be removed. Also during left sided surgery, the blood vessels supplying the kidney are also at risk. Damage to the kidney blood vessels may result in hypertension. The right adrenal gland is surrounded by the colon, kidney, liver, pancreas, small intestine and blood vessels. On the right side, the liver and duodenum (first part of the small intestine) are most at risk.
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