Currently, the issue of choosing the optimal method aimed at preserving the organ and improving the prognostic results of patients becomes a key task for endocrine surgery. In this context, we consider it appropriate to analyze the impact of the surgery intervention tactic on the adrenal gland and postoperative hormone levels.
In this retrospective cohort study, we analyzed the medical records of 56 hospitalized patients with adrenocortical adenomas (mean age of 46 years 95% CI 40-54) after adrenal gland surgery and management of such individuals at the Kyiv City Clinical Endocrinological Center. All the patients were tested for post-op cortisol and adrenocorticotropic hormone (ACTH) levels. To conduct the study, all patients were divided into two groups for further comparative analysis: the first group consisted of 30 (54%) patients with adrenal resection and the second group included 26 (46%) patients with adrenalectomy. The method of Fisher's angular transformation was applied for CI evaluation.
Analysis of the data determined the presence of statistically significant differences in post-op levels of: serum cortisol in 3 months (p=0.034) and in 12 months (p=0.049), ACTH in 3 months (p=0.003) and in 12 months (p<0.001). The further requirement of hormonal replacement therapy rate for patients after adrenal gland resection is 20% (CI 7,5-36,7) and after adrenalectomy is 46,2% (CI 26,9-66,1) (p=0,05).
Our findings demonstrate that the organ-preserving approach yields potential advantages in terms of assessment of adrenal hormonal activity and functional monitoring results, minimizing postoperative complications, and contributing to improved patient outcomes.