Summary

■ The concept of laparoscopic partial adrenalectomy or adrenal-sparing surgery includes the preservation of the functioning adrenal cortex to obviate the need for hormonal replacement therapy and its attendant, undesired consequences.

■ Partial adrenalectomy has limited application in highly selected patients, and, at the time of writing, it was not accepted treatment for the majority of surgical adrenal diseases.

■ Micro- or macronodularity in an area of the gland adjacent to an aldosteronoma is a clear contraindication for partial adrenalectomy.

■ Laparoscopic partial adrenalectomy of large-sized Cushing's adenomas is technically challenging.

■ The least controversial indication for partial adrenalectomy is hereditary pheochromocytoma. Patients with unilateral or bilateral pheochromocytomas are candidates for partial adrenalectomy because a definite risk of contralateral metachronous tumor formation exists.

■ Partial adrenalectomy has limited application in highly selected patients, and, at the time of writing, it was not an accepted treatment for the majority of surgical adrenal diseases.

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