Endocrine Surgery

The medical discipline of endocrine surgery focuses on the endocrine system, which regulates hormones. Hormones control movement, growth, sexual development, breathing, metabolism, and reproduction.

The glands produce hormones, which are then transported by the blood to other tissues in the body.  When the glands do not produce the right amount of hormones, diseases develop that can affect people's daily life.

The discipline of medicine called endocrinology deals with treating people who have hormonal imbalances. Endocrinologists carefully examine hormonal conditions and choose the most accurate treatments. They offer superior healthcare for individuals with diabetes and hormone-related conditions like obesity, infertility, thyroid problems, osteoporosis, and cancers.  (1)

To slow or stop the growth of the cancer, synthetic hormones or other medications that prevent the body's natural hormones may be administered. Surgery may also be performed to remove the gland that produces a certain hormone.  (2)

Definition and Overview

Endocrine surgery refers to procedures that focus on one or more endocrine organs. A stable internal environment and metabolism are maintained by the hormones released into the bloodstream by endocrine organs, which are glands spread throughout the body.

The pituitary and hypothalamus serve as the endocrine system's control and command centers. These glands collectively make up the endocrine system. The endocrine pancreas, pineal, adrenal, thyroid, and parathyroid glands are further endocrine glands. Endocrine surgeons are experts who operate on these glands. (3)

Procedures

The medical team may opt to do a variety of tests and diagnose the condition depending on the patient's symptoms and medical background. Here are the most common evaluations and tests:

• Fine Needle Aspiration (FNA) 

Doctors insert a fine needle to remove cells from a problem or related area for evaluation by a cytopathologist. Through repeated FNA procedures, often accompanied by an ultrasound, doctors can diagnose the endocrine disorder and create a treatment plan.

• Sestamibi Scan

It is a nuclear medicine scan. It is still used to find benign tumors that can affect the thyroid and other adrenal glands.

• Ultrasound

Sound waves are used to detect masses or fluids accumulating in soft tissues, and may even give rise to enlarged adrenal glands.

• Magnetic Resonance Imagery (MRI)

It is a non-invasive test that distinguishes between different types of tissue masses and determines whether a mass is benign or cancerous.

• Positron Emission Test (PET)

This test can detect thyroid cancers when other forms of evaluation have failed.

Depending on the affected endocrine system area and the general health of the patient, one of the endocrine surgeries is selected. Here are the endocrine surgery types.

• Adrenalectomy

This procedure helps to remove the entire adrenal gland of the patient. 

• Parathyroidectomy

It involves removing one or more of the four parathyroid glands when they are found to be overproducing parathyroid hormone.

• Thyroidectomy

When thyroid cancer or a thyroid-related adrenal disease is detected in a patient, ENT doctors may remove all or part of the thyroid with a thyroidectomy.

• Thyroid lobectomy

One or more lobes of the thyroid gland may need to be removed to remove the masses without removing the entire thyroid. (4)

Candidates

Endocrine surgery is recommended for people with a variety of endocrine disorders, such as 

• tumors, 
• hormonal imbalances, 
• other related conditions that cannot be treated with non-surgical options.

Risks and Side Effects

Endocrine surgery has risks just like any other surgical procedure does. Depending on the procedure, the patient's health, and other considerations, there are various risks and complications connected with endocrine surgery. The following are a few risks and side effects of endocrine surgery:

• Nerve Complications
• vascular Complications, including hemorrhage, Carotid artery, and jugular vein injury
• Parathyroid
• Wound healing problem
• Airway compromise and tracheal injury
• Esophageal injury
• Thoracic duct damage
• Mortality
• Diagnostic Complications
• Insulinoma
• Gastrinoma
• Pancreas-Related Complications
• Other Pancreatic Endocrine Tumors (5)

Post-Procedure and Follow-up

The surgeon might biopsy tissue from the infected gland in a lab. The tissue is examined by a specialist for indications of cancer. The results can point to the necessity for additional treatments. For instance, following thyroid surgery, patients with thyroid cancer may require radioiodine (radioactive iodine) treatment. Depending on the procedure, medication may be required either temporarily or permanently.

At a follow-up visit, the doctor will perform a physical examination and blood tests to find out the health status of the endocrine organs. For example, if the patient's thyroid gland has been removed, there should be little or no Tg in the blood. A high level may indicate that the cancer has returned. Other blood tests and additional follow-up tests may be done depending on the type of endocrine condition being treated, including 

• chest X-ray, 
• neck ultrasound, 
• whole-body scan, 
• or other imaging tests. (6)

Recovery

For starting a better recovery process, after endocrine surgery, most people need to spend at least one night in the hospital. There may be a mild sore throat. Discharge instructions should be followed closely. This will aid healing and reduce the risk of complications.

It is of great importance to rest and not lift anything heavy for a certain time, to change surgical dressings regularly when necessary, to eat soft foods to relieve sore throat, to start hormone therapy, steroids, or supplements if necessary, and to use the right medications regularly.

Results

The aim of endocrine surgery is to surgically treat various endocrine disorders such as 

• tumors, 
• hormonal imbalances, 
• and other related conditions. 

The endocrine system is made up of glands that produce hormones and other substances that regulate various body functions such as metabolism, growth, and reproduction.

Doctors often opt for endocrine surgery when non-surgical treatments are not effective or there is a risk of complications. After the operation, the patient is followed up at regular intervals and the endocrine organs are restored to health.