IS ROUTINE IPSILATERAL ADRENALECTOMY DURING RADICAL NEPHRECTOMY HARMFUL FOR THE PATIENT

To investigate the effects of unilateral adrenalectomy on the postoper ative course and laboratory parameters, 40 patients with a renal tumou r were randomized either to undergo (n = 20) or not to undergo (n = 20 ) ipsilateral adrenalectomy. Adrenal hormone (cortisol, epinephrine, n orepinephrine and aldosterone), adrenocorticotropic hormone, electroly te, creatinine, growth hormone, glucose, insulin and free fatty acid c oncentrations were measured preoperatively and postoperatively. Cortis ol and epinephrine concentrations were elevated immediately after the operation but returned to preoperative levels within the first 2 posto perative days. There were no significant differences between the adren alectomy and non-adrenalectomy groups, except that the cortisol concen tration was higher in the latter in the afternoon of the day of surger y. The conclusion is that no longterm shortage of adrenal hormones is caused by unilateral adrenalectomy. Other metabolic and endocrine resp onses were identical in the groups. Thus ipsilateral adrenalectomy doe s not seem to be harmful to the patient and the need for it must be re solved on the basis of local tumour factors.