What are the risks of an adrenalectomy?
An adrenalectomy is a relatively safe procedure with a low complication rate in the hands of an experienced endocrine surgeon. Most PA patients are released from the hospital 1-2 days after surgery and recover fully within a few weeks. Still, problems can occur with any surgery. Pneumonia, wound infections, bleeding, need for blood transfusions, and blood clots (deep vein thrombosis or pulmonary embolus) are rare, but may occur after adrenal surgery. Damage to other nearby organs may occur, but this is also rare.
Adrenal insufficiency is a potentially life-threatening complication that may occur in patients who have an adenoma that secretes both excess aldosterone and cortisol because the healthy adrenal gland becomes suppressed. Although still considered uncommon, the condition is increasingly found as more patients are treated for primary aldosteronism. To minimize the risk, patients considering adrenalectomy should make sure that their cortisol levels are properly tested during the diagnosis phase and prior to surgery. Symptoms of this condition include feeling generally unwell, nausea, vomiting, and confusion. You will likely be given an adrenal stimulation test following surgery to detect this problem. To address adrenal insufficiency, patients may need steroid medications, usually hydrocortisone, for several months until their adrenal gland recovers.