What is an Endocrine Surgery?
It is a surgery of one or more endocrine glands. Endocrine glands are glands which secrete hormones and control function of almost all the cells in the body. It is a surgical subspecialty. It includes surgery of endocrine glands, such as the thyroid gland, the parathyroid gland, the adrenal gland, glands of the endocrine pancreas, and some neuroendocrine glands.
Which are the Clinical Conditions that require Endocrinal Surgeries?
The conditions which require endocrinal surgery are as follows:
- Thyroid disorders: Underactive thyroid (hypothyroidism), overactive thyroid (hyperthyroidism), thyroid nodules, goiter, thyroid cancer, and thyroid cyst
- Parathyroid disorders: Primary hyperparathyroidism
- Adrenal gland disorders: Conn syndrome, pheochromocytoma, adrenocortical cancer, or Cushing's syndrome
- Diseases of pancreas: Insulinomas, gastrinomas, or type 1 diabetes
- Diseases of the pineal gland
- Disorders of the pituitary gland
Which surgeries are included in it?
Surgeries can be minimally invasive, such as laparoscopic surgeries or open surgeries. It includes following surgeries:
- Surgical removal of the thyroid gland (thyroidectomy) either as a part of the gland (lobectomy or hemithyroidectomy) or the whole gland (total thyroidectomy)
- Surgical removal of the parathyroid gland (parathyroidectomy)
- Surgical removal of the adrenal gland (either laparoscopic removal or open surgery)
- Adrenalectomy (i.e., surgical removal of the adrenal gland)
- Pancreatic surgery (simple tumor enucleation to larger resections)
- Surgical removal of the pineal gland (pinealectomy)
- Surgical removal of the pituitary gland (hypophysectomy or transsphenoidal surgery)
What Care needs to be Taken Preoperatively?
Following tests need to be done prior to the surgeries:
- Complete blood count
- Kidney profile
- Serum electrolytes
- Blood group
- Blood sugar
- ECG (for the patients who are 40 years and older)
- Chest X-ray (for the patients who are 60 years and older)All the tests need to be done 24 hours before the surgery.
After completing the tests, the doctor will evaluate the reports and will advise undergoing surgery accordingly.
Which medication needs to be adjusted?
Medications which need to be adjusted before the surgery are as follows:
- Aspirin, ibuprofen, and vitamin E should be stopped one week prior to surgery unless otherwise directed by the doctor.
- Dosages of coumadin, steroids, and/or insulin need to be adjusted or substituted by another medication before surgery.
What are the complications of surgery?
Following are the most common complications:
- Infection due improper aseptic precautions
- Bleeding from the surgical wound
- Change in a patient’s voice and swallowing difficulty
- Low thyroid function
- Hypoparathyroidism (low blood levels of calcium caused by the removal of the parathyroid)
- Formation of seroma (swelling caused by a collection of fluid beneath the incision site)
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