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In medical practice, adrenal surgery is considered the most difficult. To conduct it successfully, the doctor must have high skill and experience in surgery. Before choosing a method for treating the adrenal glands, the doctor must conduct a number of laboratory and instrumental studies. Only after that he can fully proceed to surgical intervention.
The adrenal glands are vital organs of the endocrine system. It is they who produce a large number of necessary hormones, namely, glucocorticoids, minerals, adrenaline, norepinephrine and sex hormones. If we take the thyroid gland, then it can be replaced by the functions of the adrenal gland, but there is no way to reverse the process.
Adrenal insufficiency occurs as a result of long-term treatment or removal of adrenal tissue. As a result of the development of such a pathological process, the patient needs to take medications throughout his life that will help the adrenal glands to work fully.
Therefore, in order to perform surgery on the adrenal glands, the patient must have a number of serious indications, we will talk about them a little later. The main indication for surgery on the adrenal glands is a tumor process in the adrenal tissues and directly in the organ itself. Recently, doctors have become more and more likely to diagnose volumetric tumors in this organ. Why is this happening?
The fact is that it is impossible to say that it was tumor processes that began to appear more often, just in recent years medicine has reached a high level that it is possible to diagnose various changes in organs in time. Previously, this was not possible, and people died without knowing the true cause of their illness.
Diseases of the adrenal glands can be diagnosed in time using ultrasound and computed tomography. What is most interesting, with the help of computed tomography, it is possible to diagnose a pathological process in the adrenal glands at the time of viewing a completely different organ located in the abdominal cavity. Such cases, of course, are not so common, but still exist. Such moments in medicine are called incidentaloma.
Previously, doctors did not really think about the method of treating such diseases. If a person was diagnosed with a tumor process in the adrenal glands, then surgery was prescribed according to the standard. To date, doctors have slightly revised their attitude to this problem and decided that it is not necessary to immediately resort to such aggressive methods of treatment.
When do doctors prescribe adrenal surgery?
In the adrenal glands, not only the tumor process can occur, but also much more. Doctors will help to prescribe an operation for patients with:
- pheochromocytoma;
- Conn’s syndrome;
- adrenocortical cancer;
- adrenal adenoma of various nature;
- lymphoma;
- myelolipoma;
- cyst;
- metastases
If the patient has at least one of the above diseases, then he is urgently prescribed surgical intervention.
How to prepare for the operation?
Before prescribing a surgical intervention, the patient is sent for additional diagnostics, which consists of:
- complete medical examination;
- general blood test;
- general analysis of urine;
- ultrasound examination of the abdominal organs;
- computed tomography;
- magnetic resonance imaging;
- radiation scan.
Also, before the operation, the patient is forbidden to drink all medications in order to find out the true cause of the malfunction of the adrenal glands.
These drugs include aspirin or other anti-inflammatory drugs and drugs that can thin the blood.
You must not eat any food for 7 hours before the operation. Doctors recommend taking an enema the night before surgery or taking medications with a laxative effect. In this way, the intestines can be cleansed. It is very important to measure your blood pressure before starting surgery. With increased pressure, surgery on the adrenal glands is strictly prohibited.
How is the operation carried out?
To begin with, the patient is given general anesthesia so that the patient sleeps during the operation. As soon as the patient falls asleep, he needs to enter antibacterial agents and appropriate hormones.
If the adrenal gland has a sufficiently large mass, then the removal occurs through the anterior wall of the abdominal cavity. This is how it is easier for doctors to get the adrenal gland out of the human body. If there are concomitant indications, then the specialists additionally examine the remaining organs that are in the abdominal cavity.
Incisions can only be made in the abdomen or chest. It is very important to properly separate the diseased organ from the kidney. As soon as the organ is taken out, they immediately begin to sew up the incision. The sooner this is done, the less likely it is to infect the wound. After suturing, a sterile bandage is applied to the operated area. If necessary, the doctor can insert a special tube into the place where the gland was removed from. This will allow you to remove excess fluid from the body.
Typically, the process takes seven days. After that, the phone is taken out. The operation takes an average of two to three hours. Maybe longer if there are associated complications.
The operation is absolutely painless, because the patient is under general anesthesia during the procedure.
Postoperative period
After the doctors remove the adrenal gland through the incision, the patient is sent to the recovery room. Here he will stay until he recovers from anesthesia. The removed organ is sent for laboratory testing to exclude or confirm the moment of malignancy.
As soon as the anesthesia begins to wear off, the patient will feel a slight twitch at the incision site, but this will soon pass. If the patient complains of pain, then he is prescribed painkillers. After surgery, if there are no serious complications, the patient is in the hospital for no more than five days. At home, the patient must strictly follow all the recommendations of the attending physician. Otherwise, serious complications may begin.