- Intraoperative Bleeding (5.4% most common complication)
On the right side, the adrenal vein is very short and drains laterally-dorsally into the inferior vena cava. The risk of injury during exposure due to traction on the vein is high in large tumors. Proximal control at the inferior vena cava is often the safest way to minimize blood loss. Aim for primary ligation/suturing/oversewing of the vessel/vessel stump or vascular clips. In case of a tear in the inferior vena cava, see below.
Prevention through early identification and secure ligation of the adrenal vein during the preparation process before the organ is fully mobilized.
- Injury to large liver veins and/or the inferior vena cava
In addition to massive bleeding, air embolisms can occur! -> Tangential clamping with oversewing, in severe cases manual compression and temporary occlusion of the inferior vena cava caudally and possibly cranially to the liver after opening the diaphragm (suprahepatic clamping).
- All organs mobilized for correct exposure of the adrenal gland can be injured:
- Capsular lesions of the liver and right kidney -> hemostatic measures (coagulation, hemostasis with fibrin glue or sealing with fibrin-coated collagen fleece)
- Injury to the duodenum -> immediate oversewing
- Diaphragmatic injury with pleural lesion can lead to a pneumothorax or pneumomediastinum, if hemodynamically significant, insertion of a chest drain.
- Hormonal reaction, particularly catecholamine-induced with intraoperative circulatory dysregulation in pheochromocytoma
-
Intraoperative Complications
Postoperative Complications
Postoperative Hemorrhage (0.2 - 6.1%) Depending on the intensity of bleeding, surgical revision may
Postoperative Hemorrhage (0.2 - 6.1%) Depending on the intensity of bleeding, surgical revision may
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