| The
endocrine system, an integrated system of small organs
that involve the release of extra cellular signaling
molecules known as hormones, is instrumental in regulating
metabolism, growth, tissue function, and also plays
a part in determining mood.
Endocrine
glands include the adrenal, parathyroid, thyroid and
pancreas. These organs produce hormones which have
important effects in regulating body functions. Surgical
treatment of these glands may be for cancer or because
a gland is producing too much of a certain hormone.
For more information about the endocrine glands and
the surgeries to remove them, click the links below.
Adrenal
Gland
Parathyroid Gland
Thyroid Gland
Pancreas
Adrenal
Gland
Adrenal
gland produces adrenaline, cortisone, and aldosterone,
which are used to balance the body’s fluid and
electrolytes. They are approximately 1-3 inches in
length and are located on the top of each kidney.
There
are two main problems that can affect the adrenal
gland: tumors (both cancerous and non-cancerous) and
the excess secretion of hormones.
An
adrenalectomy is a surgical procedure that is done
in order to remove the affected adrenal gland(s).
Removing one of the adrenal glands has virtually no
impact on the patient; the remaining gland will produce
normal amounts of hormones. However, removing both
adrenal glands will require long-term medication in
order to compensate for the gland function.
Surgery
To remove the adrenal glands, an incision is made
below the patient's ribcage. The adrenal gland, which
sits on top of the kidney, is visualized. The vein
emerging from the gland is tied off and cut, and the
adrenal gland is removed.
Recovery
Most patients will have to stay overnight in the hospital
in order for their doctor to monitor their hormone
levels. Some patients may have to extend their hospital
stay depending on how the surgery (and sudden loss
of extra hormones) effects their body. Once released
from the hospital, patients are typically able to
return to full physical activity within a few weeks.
Parathyroid
Gland
The parathyroid glands are small endocrine glands
in the neck that produce parathyroid hormone. Humans
have four parathyroid glands, which are usually located
behind the thyroid gland, and, in rare cases, within
the thyroid gland or in the chest. Parathyroid glands
control the amount of calcium in the blood and within
the bones.
Surgery
to remove parathyroid glands or parathyroid tumors
(parathyroidectomy) is recommended when one or more
parathyroid glands are producing excessive amounts
of parathyroid hormone. This condition is called hyperparathyroidism.
Surgery
Parathyroidectomy is performed while you are under
general anesthesia (unconscious and pain-free). The
surgeon makes a cut in the neck just under the Adam's
apple and locates the four parathyroid glands.
The
particular problem or disease will determine how many
of the parathyroid glands are removed. Usually, some
parathyroid tissue is left in place to help prevent
hypoparathyroidism (low levels of parathyroid hormone).
Additional
risks for parathyroidectomy include the following:
- Injury
to the thyroid gland
- Hypoparathyroidism
(leading to dangerously low calcium levels)
-
Injury to the vocal cord nerves
Recovery
Patients usually recovery very quickly after surgery,
especially when minimally invasive techniques are
used. Normal activity usually can be resumed within
a few days. Following this procedure, you should have
routine blood tests to check your calcium level.
Thyroid
Gland
The thyroid gland is found in the neck and plays a
major role in regulating the body's metabolism. It
controls how quickly the body uses energy, makes proteins,
and controls how sensitive the body should be to other
hormones.
The
most common problems of the thyroid gland consist
of an over-active thyroid gland, referred to as 'hyperthyroidism',
and an under-active thyroid gland, referred to as
'hypothyroidism'.
Thyroid
gland removal (thyroidectomy) may be recommended for
the following:
- Hyperthyroidism
(overactive thyroid)
- Hypothyroidism
(underactive thyroid) with enlargement of the gland
- Thyroid
swelling (nontoxic goiter)
- Cancer
of the thyroid
Surgery
Total thyroidectomy removes the entire gland. Subtotal
or partial thyroidectomy removes part of the thyroid
gland. Thyroidectomy is done while you are under general
anesthesia (unconscious and pain-free). The surgeon
makes a cut in the neck and locates the gland. All
or part of the thyroid gland, depending on the particular
procedure, is removed.
The
procedure may also be done if a patient with hyperthyroidism
does not want to have radioactive iodine treatment
and cannot be treated with anti-thyroid medications.
Additional
risks for thyroidectomy include the following:
- Bleeding
and possible airway obstruction
- Temporary
or permanent loss of ability to speak due to paralysis
of the vocal chords
- Inadequate
thyroid function (hypothyroidism)
- Injury
to the adjacent parathyroid glands
- Inadequate
level of calcium in the blood (hypocalcemia)
Recovery
When performed by our experienced surgeons, the outcome
of thyroid surgery is usually excellent. In general,
patients recover rapidly from uncomplicated thyroid
surgery. Most patients are able to resume most normal
activities within 1-2 weeks. Thyroid function tests
may need to continue following thyroid surgery, and
thyroid hormone replacement maybe necessary.
Pancreas
The pancreas is an organ about 6 inches long that
stretches across the back of the abdomen, behind the
stomach. The pancreas makes pancreatic juices and
hormones, including insulin. The pancreatic juices
are enzymes that help digest food in the small intestine.
Insulin controls the amount of sugar in the blood.
There
are various diseases that can affect the pancreas,
including:
- Acute
pancreatitis
-
Chronic pancreatitis
- Pancreatic
cancer
- Pancreatic
tumor
- Diabetes
mellitus
Surgery
A pancreatectomy is the surgical removal of the pancreas.
A pancreatectomy may be total, in which case the entire
organ is removed, usually along with the spleen, gallbladder,
common bile duct, and portions of the small intestine
and stomach. A pancreatectomy may also be distal,
meaning that only the body and tail of the pancreas
are removed, leaving the head of the organ attached.
When the duodenum is removed along with all or part
of the pancreas, the procedure is called a pancreaticoduodenectomy
(Whipple procedure). Pancreaticoduodenectomies are
increasingly used to treat a variety of malignant
and benign diseases of the pancreas. This procedure
often involves removal of the regional lymph nodes
as well.
Recovery
After surgery, patients experience pain in the abdomen
and are prescribed pain medication. Follow-up exams
are required to monitor the patient’s recovery
and remove implanted tubes. A total pancreatectomy
leads to a condition called pancreatic insufficiency,
because food can no longer be normally processed with
the enzymes normally produced by the pancreas. Insulin
secretion is likewise no longer possible. These conditions
are treated with pancreatic enzyme replacement therapy,
which supplies digestive enzymes; and with insulin
injections. In some case, distal pancreatectomies
may also lead to pancreatic insufficiency, depending
on the patient’s general health condition before
surgery and on the extent of pancreatic tissue removal.
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