Increased Risk of Postoperative Bleeding in Adrenalectomy for Secondary Adrenal Malignancy

Adrenalectomy for secondary adrenal malignancy (SM) poses an elevated risk of postoperative bleeding compared to benign nonfunctional (BNF) adrenal neoplasms. Among 3496 patients, those with SM were older and had higher rates of comorbidities. Laparoscopic adrenalectomy was common for both groups, with comparable mortality and morbidity rates. However, SM patients exhibited significantly higher postoperative bleeding rates (6.3% vs. 2.6%). Multivariable analysis confirmed this association, emphasizing the importance of counseling for patients meeting criteria for adrenal metastasectomy.