Figure 4 Intraoperative and postoperative findings.A. Robotic-assisted laparoscopic positioning and trocar
placement via transabdominal approach. B .The grossly excised
tissue post-surgery appears yellowish and solid, with nodular
hyperplasia observed. C . Post-surgical hematoxylin and eosin
(H&E) stained pathological section is consistent with adrenal adenoma
findings (×100).
Postoperative hormone supplementation protocol: Hydrocortisone 100 mg
was administered intravenously during the surgery. On the day after the
surgery, hydrocortisone 200 mg was administered intravenously. On the
first postoperative day, hydrocortisone 200 mg was given intravenously
(125 mg at 8:00 AM and 75 mg at 4:00 PM), and the following day, the
dose was reduced to 150 mg (100 mg at 8:00 AM and 50 mg at 4:00 PM).
After resuming normal oral intake, prednisone 30 mg per day was
prescribed orally, with a gradual reduction to 20 mg per day upon
discharge, depending on the patient’s condition. The dose was further
reduced by 2.5 mg every 4 weeks.
Regular postoperative follow-up was conducted for 2 months, with no
symptoms of adrenal insufficiency, such as anorexia, nausea,
tachycardia, apathy, or fatigue and drowsiness. The patient’s cortisol
diurnal rhythm was restored (Table 1), menstruation was regular, and the
patient’s weight decreased by 5 kg. No significant symptoms of adrenal
insufficiency or adrenal crisis were observed during the follow-up
period. Plasma cortisol and ACTH levels will continue to be monitored,
and medications may be gradually reduced or discontinued once adrenal
cortical function is confirmed to have returned to normal.