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What is Endocrine Surgery?
The term endocrine surgery involves surgical procedures performed to treat the diseases originating from the glands secreting hormones in the body. The definition of endocrine surgery, which is a sub-branch of general surgery, includes diseases developing from thyroid, parathyroid, adrenal and pancreatic secretory cells.
Which Diseases are Surgically Treated in Endocrine Surgery Department?
In endocrine surgery department, conditions caused by nodular or general enlargement of thyroid gland, cancers of thyroid gland, parathyroid gland diseases and diseases originating from adrenal glands are surgically managed.
What is a Thyroid Nodule?
Thyroid nodules are mass formations developing in thyroid gland. Those may be solid or fluid-filled or they may have mixed structure.
What are the Signs of Thyroid Nodule?
Many thyroid nodules do not manifest any symptom as long as they do not cause recognizable swellings in neck. Those nodules are mostly detected during examinations and ultrasounds. Some of these nodules compress the airway or esophagus and cause dyspnea and difficulty swallowing. The symptoms caused by elevated hormone levels due to thyroid nodules with the capacity to secrete hormones excessively include palpitation, excessive sweating and tremor in hands.
How are the Thyroid Gland Disorders Diagnosed?
Thyroid gland disorders are diagnosed with examination of neck, ultrasound, detection of changes in thyroid hormone and other thyroid-related blood tests. Palpable nodules or signs of elevated or decreased hormone levels may be noted in the examination. The structure of thyroid gland is evaluated with thyroid ultrasound. Moreover, thyroiditis can be diagnosed, nodules in thyroid gland and their characteristics can also be assessed with thyroid ultrasound. Hyperthyroidism, hypothyroidism and other thyroid disorders can be diagnosed with blood tests.
Fine needle aspiration biopsy method is utilized for evaluation of nodules detected in thyroid gland. The cells are obtained from suspicious nodules with a needle and they are pathologically evaluated; nodules that require surgical intervention are determined with this examination.
What are the Cutting Edge Methods Used in Surgical Treatment of Thyroid Gland Disorders?
Total thyroidectomy surgery, which implies the complete removal of thyroid gland, is performed for Graves’ disease –the most common cause of hyperthyroidism. If the underlying cause of hyperthyroidism is an over-functioning nodule and if there are no other nodules around the gland, thyroidectomy is performed. Generally, if cancer is diagnosed in thyroid gland, the entire thyroid tissue and –in some cancer types- the lymph nodes in that region are surgically removed with total thyroidectomy. Thyroidectomy can be unilaterally performed for some specific cases or cancer types. Those surgeries are performed with a 3-4 cm incision from the anterior part of neck.
What is Parathyroid Gland?
Parathyroid glands are the four glands at both sides of neck, on thyroid gland; they are the small glands ensuring calcium balance in body and secreting parathyroid hormone.
What are the Parathyroid Gland Disorders?
Excess growth or uncontrolled hormone secretion may develop generally in one of the parathyroid glands or –rarely- two or all of them; this condition is called hyperparathyroidism. If this condition develops in a single parathyroid gland, it is called parathyroid adenoma and if it develops in all of the glands, it is called parathyroid hyperplasia. In these conditions, the parathyroid hormone level increases in body and therefore, calcium level in blood elevates. The elevated calcium level causes many problems including formation of renal stones, osteoporosis, atherosclerosis and mood disorders.
How are Parathyroid Gland Disorders Diagnosed?
The symptom of hyperparathyroidism is elevated blood calcium level. This condition may be incidentally detected in routine blood tests while it may also be diagnosed during the examinations for diseases like renal stones and osteoporosis. Parathyroid adenomas can be detected with ultrasound. In case of hyperplasia, although the enlargement in nodes cannot be demonstrated with ultrasound, the diagnosis can be made by detecting elevated calcium and parathyroid hormone levels in laboratory examinations. Special diagnostic methods such as scintigraphy are also used in diagnosis of abnormally located parathyroid adenomas.
What are the Cutting Edge Methods used in Surgical Treatment of Parathyroid Gland Disorders?
In cases where excess growth or over-functioning is noted in one or two parathyroid glands, those glands are accessed through a small incision and removed surgically with a method called targeted parathyroidectomy. In case of hyperplasia where there is problem in all glands, a similar surgical approach with thyroid surgery is employed and subtotal parathyroidectomy is performed, which enables exposing all glands and removing half of a gland while the other parts are preserved.
What is Adrenal Gland?
Adrenal glands are the two glands –right and left- which are located on both kidneys and secrete many crucial hormones for our body.
What are the Adrenal Gland Disorders?
There are many disorders of adrenal gland. The ones requiring surgical management are disorders that are caused by mass lesions called pheochromocytoma and manifest themselves with palpitation, hypertension and facial flushing attacks; Conn syndrome that develops with symptoms such as decreased potassium level in blood, hypertension, fatigue and weakness and Cushing syndrome that causes excessive steroid hormone secretion.
How are Adrenal Gland Disorders Diagnosed?
Most of the adrenal gland disorders are diagnosed by determining the increases in blood hormone levels of the patients showing the explained symptoms in laboratory and detecting the locations of mass lesions in adrenal glands causing these anomalies with imaging methods like tomography, MRI and scitingraphy.
What are the Cutting Edge Methods used in Surgical Treatment of Adrenal Gland Disorders?
Most of the surgical procedures performed for adrenal gland are carried out with laparoscopic surgery (closed method). The diseased gland is removed with this method and patients can recover in a short time.
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