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Bilateral Adrenalectomy

Surgical removal of both adrenal glands for refractory Cushing disease, bilateral pheochromocytomas or hereditary syndromes.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Bilateral Adrenalectomy?

Bilateral adrenalectomy involves removing both adrenal glands and is indicated for refractory Cushing disease after failed pituitary surgery, ectopic ACTH-dependent Cushing syndrome with unresectable primary tumor, bilateral pheochromocytomas (often in MEN2 or VHL syndromes), bilateral macronodular adrenal hyperplasia and bilateral cortisol-secreting adenomas.

Laparoscopic posterior retroperitoneal or transabdominal approaches are preferred and offer reduced morbidity. In hereditary syndromes, cortical-sparing adrenalectomy may be considered to preserve adrenal function and avoid lifelong glucocorticoid replacement, though with increased recurrence risk.

Postoperatively, patients require lifelong glucocorticoid and mineralocorticoid replacement and emergency precautions to avoid adrenal crisis. Nelson syndrome (corticotroph adenoma growth in residual pituitary) is a specific concern after surgery for Cushing disease.

Symptoms

Refractory hypercortisolism
Bilateral pheochromocytoma
Hypertensive crises
Adrenal hyperplasia
Hereditary tumor syndromes
Multiple endocrine adenomas
Severe systemic complications

Risk Factors

Failed pituitary surgery for Cushing disease
Ectopic ACTH syndrome
MEN2 syndrome
Von Hippel-Lindau syndrome
Bilateral macronodular hyperplasia
Family history of adrenal tumors
Refractory medical therapy

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent hypercortisolism after pituitary surgery
  • Bilateral pheochromocytoma diagnosis
  • Severe Cushing complications
  • Hereditary syndrome with bilateral disease
  • Failure of medical management
  • Cardiovascular instability

Treatment Methods

01
Laparoscopic posterior adrenalectomy
02
Transabdominal laparoscopic approach
03
Cortical-sparing partial adrenalectomy
04
Lifelong glucocorticoid replacement
05
Mineralocorticoid replacement
06
Pituitary monitoring (Nelson syndrome)
07
Genetic counseling and surveillance

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.