Incidentalomas, Myelolipomas, and Cysts
We suggest that patients with moderate to severe ACTH-dependent hypercortisolism refractory to source control undergo bilateral laparoscopic adrenalectomy to ameliorate cortisol excess and improve disease-free survival and mortality. Postoperative adrenal insufficiency is a life-threatening condition that should be prevented and promptly managed in patients undergoing adrenalectomy. Symptoms include fatigue, hypotension, anorexia, abdominal pain, weakness, syncope, back pain, nausea, vomiting, fever, and confusion.(C, L)
Metastasis to the Adrenal Gland
Pheochromocytoma and Paraganglioma
The utility of percutaneous ablation, mainly with radiofrequency ablation, and stereotactic body radiation therapy for the destruction of hormonally active and inactive tumors and adrenal metastasis has been investigated in small retrospective studies. The studies suffer from small sample sizes and heterogeneity.
August 17, 2022
Supplemental Implementation Tools
Country of Publication
Adrenalectomy is the definitive treatment for multiple adrenal abnormalities. Advances in technology and genomics and an improved understanding of adrenal pathophysiology have altered operative techniques and indications. Objective is to develop evidence-based recommendations to enhance the appropriate, safe, and effective approaches to adrenalectomy.
Male, Female, Adult, Older adult
Health Care Settings
Hospital, Outpatient, Operating and recovery room
Nurse, nurse practitioner, physician, physician assistant
D000315 - Adrenalectomy
Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhits MJ, Han MA, Smith PW, Wilhelm S, Asa SL, Fahey TJ 3rd, McKenzie TJ, Strong VE, Perrier ND. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022 Aug 17. doi: 10.1001/jamasurg.2022.3544. Epub ahead of print. PMID: 35976622.