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Concept
Adrenalectomy
Summary
Adrenalectomy (Latin root Ad "near/at" + renal "related to the kidneys" + Greek ‐ectomy “out-cutting”; sometimes written as ADX for the procedure or resulting state) is the surgical removal of one (unilateral) or both (bilateral) adrenal glands. It is usually done to remove tumors of the adrenal glands that are producing excess hormones or is large in size (more than 2 inches or 4 to 5 centimeters). Adrenalectomy can also be done to remove a cancerous tumor of the adrenal glands, or cancer that has spread from another location, such as the kidney or lung. Adrenalectomy is not performed on those who have severe coagulopathy or whose heart and lungs are too weak to undergo surgery. The procedure can be performed using an open incision (laparotomy) or minimally invasive laparoscopic or robot-assisted techniques. Minimally invasive techniques are increasingly the gold standard of care due to shorter length of stay in the hospital, lower blood loss, and similar complication rates.
One adrenal gland sits above each kidney. The two adrenal glands produce hormones (steroid hormones and catecholamines) that help regulate blood pressure, blood sugar level, metabolism, immune system, stress and other essential functions. If one adrenal gland is removed, the other adrenal gland will take over the hormone-producing role. If both adrenal glands are removed, the patient will require lifelong steroid supplementation.
Adrenal tumor
Most adrenal tumors are noncancerous (benign), often found incidentally as a mass via imaging such as CT scans, MRI, or ultrasound that were taken for other health workups (see incidentaloma). Although these adrenal masses do require evaluation, the majority of them (approximately 80%) do not require adrenalectomy. However, due to the hormone-producing function of the adrenal glands, some noncancerous adrenal tumors may produce too much hormones, such as aldosterone (called primary aldosteronism), cortisol (called Cushing's disease or Cushing's syndrome), or catecholamines (called pheochromocytoma).
Official source
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