Does the adrenal gland need to be removed along with the kidney?
During a traditional radical nephrectomy, everything within Gerota’s fascia is removed, including the adrenal gland. However, recent studies reveal that clinical stage T1 or T2 tumors located in the middle or lower part of the kidney (away from the adrenal) rarely involve the adrenal gland. If two adrenal glands are present, the one adjacent to the involved kidney should be removed when any of the following criteria are present: the adrenal gland appears to contain tumor based on CT scan or intraoperative findings, the tumor is near the adrenal gland (in the upper portion of the kidney) or the tumor is clinical stage T3 or T4. When the patient has bilateral kidney tumors or a solitary adrenal gland, sparing the adrenal gland may be considered even when the previous criteria are present. When the tumor is clinical stage T1 or T2 and located in the middle or lower part of the kidney, leaving the adrenal behind is associated with minimal risk and may prevent future problems. A person can
