Retrospective Review of Adrenalectomy in a Tertiary Center in Nepal

IntroductionAdrenal gland surgery is a challenging art as it encompasses diverse physiological derangements which are evenlife-threatening. Also, it remains a medical finesse to rightly identify the correct patient who will benefit fromsurgery which include strong biochemical and radiological resource. Soundly performed surgery will lead tooncologic and homeostatic correction leading to near normal course.MethodsThis is a retrospective analysis of adrenalectomy cohort over three years in a tertiary center in Nepal identifyingdiagnosis, perioperative management and postoperative course. The objective of this study is to review thepresentation, histopathology and clinical outcomes of patients operated for adrenal mass in our center.ResultsThere were 42 surgeries performed via open approach. The number of adenoma, phaeochromocytoma, carcinomaand non-functioning tumor were 13, 16, 12 and one respectively. In most of the hypertensive patients, controlwas achieved with minimal drug and recurrences were observed in 25% of carcinoma in postoperative follow up.ConclusionA large proportion of operative adrenal mass are observed clinically in our setup. The surgical outcome issatisfactory but judicious perioperative management is essential.KeywordsAdrenalectomy, adrenocortical carcinoma, phaeochromocytoma