Wednesday, January 03, 2018 by Zoey Sky
An adrenalectomy is defined as an organ-removal surgery that removes one or both of the adrenal glands. The adrenal glands, two small organs located above each kidney, secrete hormones that aid in the regulation of various bodily functions such as your immune system, metabolism, blood sugar levels, and blood pressure control.
Individuals with benign or cancerous tumors in their adrenal glands often need an adrenalectomy. During the procedure, surgeons may remove one or both of the adrenal glands if they have a tumor. If only one adrenal gland is removed, the remaining adrenal gland can simply take over and provide full functioning.
If one or both of an individual’s adrenal glands produce too much of a hormone, an adrenalectomy may be required. The production of excess hormone is a symptom of a tumor in the adrenal glands.
Known side effects of an adrenalectomy
Several complications can occur after an adrenalectomy. These include:
- Inadvertent injury to the surrounding structures — Vascular injuries can be linked to hemorrhaging or the ligation of vessels not associated with the adrenal gland.
- Damage to adjacent organs — This can depend on the approach taken, with the anterior/thoracoabdominal approaches resulting in more bowel injuries. Patients are also at risk for wound complications, e.g. breakdown, soft-tissue infection, and dehiscence, which is a complication that is characterized by a wound rupturing along a surgical incision.
- Various complications — Can be caused by hormonally active tumors and some complications such as hyperkalemia and hypotension
- Adrenal insufficiency — A severe complication of resection for Cushing syndrome can occur if it is not diagnosed immediately, aggressively treated, and prophylactically guarded against via steroid replacement. Hypoglycemia and hyperglycemia also may be seen postoperatively.
Body systems harmed by an adrenalectomy
The risks of undergoing adrenalectomy include major hormone imbalances due to the underlying disease, the surgery, or both. These are linked to health concerns about healing, blood pressure fluctuations, and other metabolic problems.
Other risks include:
- Damage to adjacent organs (e.g. spleen, pancreas)
- Loss of bowel function
- Blood clots in the lungs
- Lung problems
- Surgical infections
Patients may also experience complications after an adrenalectomy. General post-surgical dangers include:
- Excessive bleeding
- Slow healing
- Blood clots in the legs
- Fluid retention
- Adverse reaction to anesthesia
Food items or nutrients that may prevent an adrenalectomy
There are no known foods that can help this condition.
Treatments, management plans for an adrenalectomy
The following treatments and management plans can be used for a patient who has undergone an adrenalectomy:
- Primary hyperaldosteronism — The management of bilateral adrenal hyperplasia is centered on medical therapy.
- Cushing syndrome — Thanks to advancements in localization, Cushing disease is treated with bilateral adrenalectomy only when ablation of the pituitary through radiation or surgery has failed or when medical therapy cannot control secretion.
- Pheochromocytoma — Preoperative management of pheochromocytoma aims to control the catecholamine secretion and its cardiovascular sequelae.
- Posterior approach — Typically used for small tumors, the posterior approach was previously recommended for bilateral exploration in bilateral hyperaldosteronism. Now, localization studies are mandatory prior to bilateral exploration for adenomas.
- Modified posterior approach — A true posterior approach can be used in a more cephalad manner and gain transthoracic access to the adrenals.
- Flank approach — An extraperitoneal, extrapleural 11th or 12th rib flank approach as used for a radical nephrectomy provides excellent exposure for right or left adrenalectomy.
- Transabdominal approach — Transabdominal approaches are often used in the pediatric population and for patients with large malignancies.
- Primary hyperaldosteronism – Aims to achieve blood pressure control with spironolactone.
- Pheochromocytoma – Aims to control the catecholamine secretion and its cardiovascular sequelae.
Where to learn more
An adrenalectomy is defined as an organ-removal surgery that removes one or both of the adrenal glands.
Individuals with benign or cancerous tumors in their adrenal glands often need an adrenalectomy.
The risks of undergoing adrenalectomy include major hormone imbalances due to the underlying disease, the surgery, or both.