The two adrenal glands are located above each kidney. They can be affected in their morphology (increase in size, benign or malignant tumor) or in their endocrine function: a decrease/increase. Each adrenal gland consists of two layers that produce several hormones:
For the cortex: cortisone, aldosterone and derivatives of sex hormones
For the spinal layer: adrenaline and norepinephrine (stress hormones, high blood pressure)
Due to the complexity of certain diseases of one or both adrenal glands, multidisciplinary management is often necessary involving endocrinologists, radiologists, surgeons… Etc.
The preparation of the operation requires further investigations: hormonal dosages, radiological examinations (CT-scan or MRI) and nuclear medicine (Scintigraphy).
Benign or malignant tumours can occur in one or both adrenal glands. depending on the relationship with their hormonal production, functional and non-functional tumours are distinguished
What type of operation:
In case of hyperfunction, it is sometimes necessary to prepare the operation with medications to take before the procedure. Depending on the diagnosis and type of tumour,:
A unilateral total adrenalectomy:
Invasive minimal surgery (laparoscopy): depending on the size and low risk of cancer
By open surgery (laparotomy) for large tumors or suspected cancer
Subtotal adrenalectomy: partial resection of the gland in very specific situations
A total bilateral adrenalectomy if both glands are affected. Hormone replacement therapy is then required.
Benefits of the operation:
The resection of the adrenal gland has been performed because it is the only possible treatment or diagnostic examination.
What are the risks during and after the operation:
Functional tumours require continuous care monitoring while the body is balancing (monitoring blood pressure or other hormone effects).
A hemorrhage is possible as an injury to the neighbouring organs. This may require a drain or other monitoring.
Endocrinological monitoring is required for certain functional tumours. Provisional post-operative drug treatment is sometimes necessary.