The relationship between operative volume and perioperative outcomes after several oncologic operations is well documented. Recent studies on adrenalectomy reveal a robust association between higher surgeon volume and improved patient outcomes. Statistical analyses have demonstrated that outcomes are improved when surgeons perform at least six adrenalectomies annually; based on this threshold definition of a 'high-volume' surgeon, more than 80% of adrenalectomies in the United States are performed by 'low-volume' surgeons. When compared to low-volume surgeons, high-volume surgeons on average achieve lower rates of postoperative complications and mortality, as well as a shorter length of hospital stay, and lower cost of hospitalization. There does not appear to be a similar association between hospital adrenalectomy volume and improved patient outcomes; however, there is evidence of benefit for the subset of patients with adrenocortical carcinoma. Despite limitations of existing literature, evidence is sufficient to recommend the referral of patients with adrenal tumors to high-volume surgeons.

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肾上腺皮质手术的容积-结果关系：现有文献综述。

多次肿瘤手术后，手术量与围手术期结局之间的关系已得到充分证明。肾上腺切除术的最新研究表明，较高的手术量与改善的患者预后之间有着密切的联系。统计分析表明，如果外科医生每年至少进行六次肾上腺切除术，结果会得到改善。根据“高容量”外科医生的阈值定义，在美国，超过80％的肾上腺切除术是由“低容量”外科医生进行的。与小批量的外科医生相比，大批量的外科医生平均降低了术后并发症和死亡率，缩短了住院时间，降低了住院费用。医院肾上腺切除术量和患者预后改善之间似乎没有相似的关联。但是，有证据表明肾上腺皮质癌患者的这一部分受益。尽管现有文献有限，但有足够证据推荐将肾上腺肿瘤患者转诊给大剂量外科医生。