Adrenalectomy

We suggest that washout characteristics on an adrenal protocol CT be used to stratify the risk of malignancy for adrenal nodules when noncontrast HU are greater than 10 and other clinical risk factors for malignancy are not present. Adrenal protocol CT does not improve diagnostic accuracy for nodules with noncontrast HU less than 10 nor does it improve evaluation for pheochromocytoma. (C, L)

We recommend that patients undergo laparoscopic adrenalectomy for unilateral PA because they are more likely to use fewer medications with lower defined daily doses to achieve normalization of blood pressure and potassium levels and have lower risks of new-onset atrial fibrillation, chronic kidney disease, stroke, and all-cause mortality. (S, L)