Endocrine Surgery

Endocrine surgery involves commonly the surgical treatment of thyroid gland, the parathyroid glands, and the adrenal glands.

The thyroid gland pathology that is treated by surgery can involve:  

-Solitary symptomatic nodules of the thyroid gland, over 4 cm in size

-Active thyroid nodules

-Tumors of the thyroid gland

-Nodular goiter

The parathyroid gland pathology that is treated by surgery can involve: 

– Tumors of the parathyroid gland, (adenoma, carcinoma)

The adrenal gland pathology that is treated by surgery can involve: 

-Functional adrenal tumors

-Malignancy suspicion or malignant tumor

-Pheochromocytoma

-Non-functional tumors with malignancy risk

-Metastatic tumors

Adrenalectomy

-The adrenal glands belong to the endocrine system and they are a pair of triangular shaped glands, each about 5cm long and 2.5cm wide, which rest on top of the kidneys.

-The adrenal glands are responsible for releasing hormones that regulate metabolism, immune system function, and ionic balance in the bloodstream and the body’s response to stress.

-The particular location of the gland and the secreting aspect of certain tumours make its removal difficult.

Postoperative attitude:

– The postoperative attitude is not influenced by the right or left side, but mainly the type of tumour, in case of tumours that produce hormones.

-Day0- The patient is allowed to drink water for his comfort

-Day1- The patient is authorized to have a light diet, mobilization is recommended. In terms of parameters, special attention is paid to blood pressure control.

-Day2 – If the control blood sample and the parameters are physiological limits, mobilization is resumed and if the patient is in good general condition, discharge is authorized.

Complications:

-Bleeding – related to the slippage of a clip from a blood vessel, or a damage to the liver or spleen.

– Blood pressure disorders – postoperative hemodynamic monitoring with the demonstration of arterial hypertension following impregnation of catecholamines treated first-line with beta-blockers, or hypotension which requires vascular filling and the administration of vasopressors  (if surgery is performed for a pheochromocytoma)

– Pneumothorax – especially for large lesions that require extensive dissection in the diaphragm. If the pneumothorax is large and symptomatic, thoracic drainage may be necessary.

– Pulmonary embolism – Prevention consists in early mobilization, compression stockings and low-molecular-weight heparin.