Part of “CHAPTER 89 – SURGERY OF THE ADRENAL GLANDS“

For hypercortisolism caused by a hyperfunctional adrenal adenoma, successful adrenalectomy is curative, and the prognosis is excellent (Table 89-4). Due to atrophy of normal adrenal tissue from chronic suppression, the continued administration of glucocorticoids is necessary postoperatively for these patients. Hydrocortisone may be administered at a maintenance dosage of 12 to 15 mg/m² per day. Mineralocorticoid replacement is
not required. Glucocorticoid replacement therapy is continued until the pituitary-adrenal axis recovers, which may take up to 2 years; recovery can be definitively evaluated with an ACTH stimulation test.11 Postoperative hormone replacement therapy is generally unnecessary for patients who undergo unilateral adrenalectomy for other conditions.