To the Editor I read with great interest the article by Fiore and colleagues, which found that adrenal insufficiency after multivisceral resection with en bloc adrenalectomy is frequent even in patients with adequate preoperative function.1 They show that, despite this, adrenalectomy can be safely performed because all considered secondary outcomes failed to identify any major clinical implication in patients developing adrenal insufficiency. I congratulate the authors for their effort in conducting this study. However, I would like to raise some concerns about the methods and results.