Results of adrenalectomy with various surgical approaches in the treatment of different diseases of the adrenal glands.

In a retrospective study, the impact of the various possible approaches for adrenalectomy were analyzed in 90 patients undergoing 120 adrenalectomies in one or two operations. The posterior approach proved to be the best tolerated procedure as expressed by the shortest operation time (less than 60 minutes) and the lowest blood loss (less than 100 milliliter). The number of opiate injections required was the lowest with this operation and the ambulation earliest (on the first postoperative day). Only two instances of wound infection, both from dorsal incision, occurred in operations for hypercortisolism in 46 patients (4 per cent). Splenectomy was necessary in four of 32 laparotomies (12 per cent), mostly for pheochromocytoma. There was no operative related mortality. The preoperative measures to reduce preoperative and postoperative complications are given.