Adrenalectomy is the treatment of an adrenal tumor.

Adrenalectomy — treatment of an adrenal tumor by surgery (removal of one or both adrenal glands).

The adrenal glands are responsible for regulating the body’s metabolism. They consist of two layers: cortical and cerebral. Each layer produces its own hormones. Thus, in the brain substance there is the production of adrenaline and noradrenaline, which are responsible for the work of blood vessels and the heart. Cells of the cortical substance produce corticosteroids. All of them affect the metabolic processes in the body. Therefore, if any cancerous processes develop in the structure of the adrenal glands, there may be disorders in the work of the whole body.

Typically, cortical layer tumors are most often benign. Neuroblastoma and pheochromocytoma develop from the inner layer of the adrenal gland. In addition, there are tumors that affect both layers of the adrenal gland, they are called insidentalomas. About 10% of all adrenal tumors are malignant. Unfortunately, it often happens that the adrenal tumor is a metastasis of other tumors: lung cancer, stomach cancer, skin cancer. Therefore, it is extremely important, when an adrenal tumor is detected, to perform a whole body examination to rule out other sources of neoplasia.

The main surgical treatment for adrenal tumors is adrenalectomy.

The most common method of adrenalectomy is laparoscopic adrenalectomy.

Laparoscopic removal is most appropriate because the tumors are most often small and easy to separate from the surrounding tissue. The gland has a loose structure, which also helps to quickly differentiate it from other tissues. In addition, the adrenal glands are adjacent to many vital vessels, which is important to be aware of during surgery. Given the retroperitoneal location of the tumor, wide accesses are usually required. However, this leads to an increase in complications. Therefore, laparoscopic surgery is the main method of removing the majority of tumor masses. Several endoscopic techniques are distinguished in laparoscopic surgery. The results of surgery depend on the choice of technique for each specific patient, on the type of tumor, on the patient’s preliminary preparation for surgery.

Like any surgery, laparoscopic adrenalectomy has its own indications for its performance. The main indication for surgery is hormonally active tumors of any size, as well as hormonally inactive tumors over 4 cm in size.

In addition to laparoscopic methods of adrenal tumor removal, other types of surgery are used. Thus, if the tumor size is more than 10 cm, it is not always possible to perform laparoscopy, as in such cases the tumor has already grown into the surrounding tissues, which requires open access. Also, laparoscopic surgery is usually not performed for malignant tumors, but if it is a small tumor or metastasis, then in some cases this operation can be performed.

Adrenalectomy is fundamentally divided into two types depending on the initial access.

The first option is transabdominal, when the endoscope is inserted through the anterior abdominal wall. This method is convenient because, if necessary, you can immediately switch to open access, without wasting time.

The second method is retroperitoneal. It is more adhered to by urologists. In addition, depending on the localization of the process, adrenalectomy can be unilateral and bilateral.

Given that the adrenal glands produce various hormones, it should be remembered that after surgery may occur adrenal insufficiency, which should be corrected before surgery. For this purpose, various drugs are prescribed: alpha-adrenoblockers, hormonal therapy, correction of electrolyte disorders.

Thus, adrenalectomy for adrenal tumor is a fairly common operation in which the number of postoperative complications is the lowest.

However, one must keep in mind the comprehensive qualified examination for a precise diagnosis and, accordingly, the choice of the best possible treatment for adrenal tumors, which can be obtained from our leading endocrinologists and oncologists in Munich.

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