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Removal of the adrenal gland (adrenalectomy) is an operation in which the adrenal gland is surgically removed. This is one of the main methods of treating tumors of this organ. It is performed extremely rarely. In the modern world, doctors most often resort to laparoscopy. The operation is performed through 4 small incisions to remove paired glands in case of tumors in them. It is worth noting that when one is removed, the second takes all the load on itself. If both are removed, then the patient takes hormonal drugs for the rest of his life. Experts believe that this is an extreme measure if drug treatment does not bring the desired results.
Regardless of whether it is a benign tumor or malignant, a person in the body experiences an excessive synthesis of certain hormones that negatively affect the entire functioning of internal organs. After the operation, the hormonal background is completely restored, and malignant tumors do not affect the lymph nodes and organs.
Removal of the adrenal glands is also performed to combat neuroblastoma. This is a special type of tumor, which is also prone to the synthesis of hormones. It is common among children. Neuroblastoma is congenital and most often develops without manifesting itself. In 30% of cases, it is the adrenal gland that is affected by such a tumor.
Preparing for the operation
Hormones that are not at the normal level bring negative consequences to a person. They can play a cruel joke on the patient, because they lead to an increase in blood pressure and an increased level of potassium in the blood.
Such disorders must be dealt with before surgery. The doctor prescribes the patient medications that are right for him. In addition, a person must undergo additional procedures in order to accurately determine the location of the tumor. Before surgery, the patient must tell the surgeon about taking medications, if any, give up bad habits, and on the eve of the operation itself, clean the intestines by enema.
If this is a woman and she is in a position in the early stages, it is important to tell the doctor about this. It is also necessary to strictly follow all the doctor’s instructions and ask him about the drugs that will then be needed for rehabilitation.
Indications for the operation
An operation to remove the adrenal glands is prescribed by a surgeon and an endocrinologist. The most common reasons for surgery include:
- found a malignant tumor of the adrenal gland;
- revealed a pathology associated with the synthesis of hormones;
- enlarged glands.
The operation is carried out either in an open way, or resort to laparoscopy. The latter option is more gentle, and it is used in case of detection of a benign neoplasm.
An open operation is prescribed in the presence of a tumor of more than 10 cm, damage to the lymph nodes by metastases, detection of carcinoma.
Contraindications for surgery
If the patient has a neoplasm, it must be operated on. However, there are a number of contraindications, due to which surgical intervention is unacceptable. Among the most basic are:
- coma. At the time the problem is discovered, the person is in a coma or doctors have discovered a specific condition in him: the transition from life to death;
- cardiopulmonary, renal failure;
- laparoscopy is not performed in patients with overweight (grade 3 obesity);
- adhesions and scars of the abdomen;
- diaphragmatic hernia;
- the presence of infectious diseases.
Alternative methods of treatment are chosen by the doctor exclusively individually, based on the patient’s vital signs.
For benign tumors, medical treatment, including hormones, can be used.
The disadvantage of this method is that you cannot count on a positive and quick result. If a malignant neoplasm is found, then it is removed only with the help of surgical intervention.
The period of rehabilitation after adrenalectomy
After the operation, the patient is given an anesthetic and the state of the drainage system is monitored. The patient gradually comes out of anesthesia. Doctors monitor his well-being, and after a few hours they allow him to drink water, a little later they give him liquid food. An important point is the control of the gastrointestinal tract to avoid the formation of adhesions.
In the case of laparoscopy, the patient can get up and start moving the very next day. In this case, an extract from a medical institution is possible in a few days. The sutures are removed after at least 7 days. If one gland was removed, then the doctor does not prescribe hormonal preparations. In the case of the removal of two adrenal glands at once, a hormonal course is prescribed for a lifetime.
After the operation, the patient is under the supervision of the attending physician for a long time. The most important thing is to fully adhere to the doctor’s recommendations, otherwise pathologies that are unfavorable for the recovery of the body may develop. These include blood clots, shortness of breath, interruptions in the work of the heart, which can lead to a stroke or heart attack. In addition, there is a risk of getting a postoperative hernia, disruption of the intestines, and so on.
Endocrinologists strongly recommend not to forget about the problem and constantly come to the examination. Especially if both adrenal glands are removed and hormones are prescribed. If you take them randomly and do not control the reception, there is a huge risk of developing new neoplasms.