Recurrent Cushing's disease and intermittent functional adrenal cortical insufficiency following subtotal adrenalectomy

Complications following adrenal surgery

The morbidity associated with adrenalectomy can be as high as 40% and the mortality is approximately 2% to 4%. Morbidity following adrenalectomy is associated with intraoperative injury to an adjacent or contiguous structure, postoperative infection, thromboembolism, or adrenal insufficiency. Mortality is most often associated with pulmonary emboli, sepsis, a myocardial event (myocardial infarction or arrhythmia), or as a direct result of the underlying disease for which adrenalectomy is being performed. The posterior approach to adrenalectomy is associated with less blood loss and morbidity, and is best tolerated by the patient. However, the anterior transabdominal approach offers superior access to both adrenals, as well as other pertinent abdominal and retroperitoneal sites, and structures requiring concomitant exploration.