Referral pattern & biochemical work-up of adrenal lesions and the role of endocrinologists in managing patients undergoing surgical adrenalectomy: A single centre audit of 10 years of laparoscopic adrenalectomies

Results: 71 adrenalectomies were performed during the 10 years between 2001 and 2010. Of these, 55 clinical notes were available for review. Male : Female, 24:31. Most patients (18) were between 50 and 60 years old. There was equal gender distribution amongst all age groups except the 21 to 30 year group (Male : Female, 0:4). 5 of the 55 referrals were from other regional hospitals via local endocrinologists. Of the 55 cases, 33 were referred by the endocrinologists, 13 by physicians from other medical subspecialties, 8 were referred by other surgical subspecialties of which 4 were from the local urologists without a specialist interest in adrenal surgery, and a single referral directly from a primary care physician. Preoperative biochemical screening varied from case to case depending upon each individual clinical presentation. Preoperative imaging showed an equal distribution between right and left sided lesions (24 each), with 7 cases having bilateral adrenal involvement. In all cases the lesion was solitary. Preoperative radiological investigations involved ultrasound scans in 5 cases, CT scans in 50 cases of which 5 had this done for staging purposes. 11 patients had undergone magnetic resonance imaging (MRI) of which 2 had also had an MRI of the pituitary. No patient had either MIBG or PET scans as a part of their imaging protocol.