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Adrenal Glands

Functions

The adrenal glands produce a number of various hormones (mineralocorticoids, glucocorticoids, sex hormones and stress hormones). The release of these hormones is controlled by the pituitary gland.

 

Location

Both adrenal glands are located on the top of the kidneys.

 

Diseases of the Adrenal Glands

On this page you will find the causes, diagnosis, symptoms, indications, and surgical therapies for the following diseases of the adrenal glands:

  • Functioning benign adrenal tumors
  • Non-functioning masses of the adrenal glands
  • Malignant adrenal gland tumors

Indications

  • hormonaktive gutartige Nebennierentumore (Nebennierenadenome, Phäochromozytome)
  • hormoninaktive Nebennierenvergrößerungen (über 5 cm Größe)
  • bösartige Nebennierentumore (Nebennierencarcinome)

 

Indications for surgery

  • Functioning (excreting hormones) benign adrenal tumors (adrenal adenoma, pheochromocytoma)
  • Non-functioning masses of the adrenal glands (more than 5 cm in size)
  • Malignant adrenal tumors (adrenal carcinoma, malignant pheochromocytoma)

 

Surgical Therapy

A thorough endocrinological examination of the adrenal glands must be done prior to surgery. Surgery is done under general anesthesia.

During the last years the use of minimal invasive surgery for adrenal gland tumors has steadily increased. The main advantage of this procedure are the considerably smaller incisions. Instead of an incision of about 15-20 cm, only four 1-1.5 cm incisions are necessary. The minimally invasive removal of an adrenal gland can be performed either through the abdominal cavity (laparoscopic) or through the back (retroperitoneoscopic).

The method of surgery depends upon the location, size, and type of adrenal gland tumor and is planned individually with each patient.

In rare cases, where both adrenal glands are enlarged (f. e. in hereditary pheochromocytoma), a new surgical procedure of partial removal (subtotal adrenalectomy) is performed. This surgical technique is performed only in some hospitals. The advantage of this procedure is the preservation of the body's own hormone production making it unnecessary for the patient to take hormone medication for the rest of the his/her life.

 

Complications

Due to their location in the body, adrenal glands are difficult to gain access to. The right adrenal gland is very close to the large vena cava (large vein leading to the heart), to the duodenum, and to the large intestine. The left adrenal gland is next to the spleen, the pancreas, and the large intestine. In rare cases occurrences of injury to one of the mentioned adjacent organs have been observed, especially with extensive malignant tumors.

 

Aftercare

During the first few hours after surgery the patient is monitored in the intensive care unit or recovery room. In the following days physical therapy is started and the wounds are cared for. After 10 days the stitches are removed. The patient is released from the hospital 6-8 days after surgery. Further care and aftercare is done together with the patient's family doctor, internist, or endocrinologist.

 

Consultation

Consultation for endocrine surgery is once a week on Wednesdays at the University of Heidelberg Hospital for Surgery from 13:00-15:30. The consultations are done in cooperation with by a surgeon and an endocrinologist from the University Hospital.

 

To make an appointment, please call in advance. Contact person is Mrs. Carolin Galm (Tel: 06221-56-36217)

 

Should you have further questions or prefer e-mail contact it would be our pleasure to answer these: carolin.galm@med.uni-heidelberg.de