Year 2014 Vol. 22 No 6

GENERAL AND SPECIAL SURGERY

.N. SADRIEV1, .D. GAIBOV1,2

SIMULTANEOUS OPERATIONS IN SURGICAL ADRENAL DISEASES

Tajic State Medical University named after AbuAli Ibn Sino 1,
Republican Scientific Center of Cardiovascular Surgery 2,
Dushanbe,
The Republic of Tajikistan

Objectives. To study the influence of simultaneously performed abdominal and retroperitoneal operations on the quality, duration and severity of adrenalectomy.
Methods. The results of diagnosis and treatment of 7 patients with the adrenal glands tumors have been analyzed; the patients had a variety of related surgical diseases requiring surgical treatment. Nine patients with adrenal tumors underwent only adrenalectomy were taken as the control group. Topical diagnosis of adrenal tumors and related pathologies was made using ultrasonography and computed tomography letting to establish accurate diagnosis.
Results. Arterial hypertension was considered to be the main clinical symptom of all forms of adrenal tumors. All patients had a statistically significant increase (p <0,05) levels of the blood hormones and their metabolites in the urine. Character and volume of the preoperative antihypertensive therapy depended on the severity of hypertension and related cardiovascular and surgical pathologies.
The wide open surgical approaches, such as lumbar-laparotomy or thoraco-phrenico-lumbar-laparotomy have been used in all cases. Despite the volume and severity of simultaneous operations in patients of the main group, postoperative complications and length of hospitalization were less than in the control group. Within five-year observation there were no any data for recurrence and mortality in these patients.
Conclusion. To patients with adrenal tumors and surgical comorbidity of other organs it is advisable to carry out the simultaneous surgical correction, as it does not lead to a significant increase of the number of complications and mortality. When planning simultaneous operations in patients with adrenal gland tumor it is important to determine the level of anesthetic risk and choose the surgical access. Such operations should be performed in clinical centers with modern equipment by skilled surgeons possessing by sufficient practice in treating patients with adrenal diseases.

Keywords: adrenal tumors, pheochromocytoma, adrenalectomy, simultaneous operations
p. 678-686 of the original issue
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Address for correspondence:
734003, Respublika Tadzhikistan,
g. Dushanbe, prospekt Rudaki, d. 139.
Tadzhikskiy gosudarstvennyiy meditsinskiy universitet
imeni Abuali ibni Sino, kafedra khirurgicheskih bolezney 2,
tel.: 992 915 25 00 55
e-mail: sadriev_o_n@mail.ru
Sadriev Okildzhon Nemadzhonovich
Information about the authors:
Sadriev O.N. A postgraduate student of the surgical diseases chair 2 of Tajic State Medical University named after AbuAli Ibn Sino.
Gaibov A.D. Corresponding Member of Academy of Medical Sciences of the Ministry of Health and Social Protection of the Republic of Tajikistan, MD, professor of the surgical diseases chair 2 of Tajic State Medical University named after AbuAli Ibn Sino, curator of the vascular surgery department of Republican Scientific Center of Cardiovascular Surgery.
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