Technique Speeds Adrenal Gland Recovery After Surgery
A new surgical technique pioneered at the Carling Adrenal Center in Florida allows for faster recovery of adrenal gland function after removal of an adrenal tumor.
The adrenal glands are a pair of small, triangular organs located above the kidneys. They are responsible for producing a number of hormones that help regulate a variety of bodily functions, from blood pressure to immune function and metabolism.
A tumor in an adrenal gland can lead to hormonal disorders like Cushing’s syndrome, which is characterized by unusually high levels of a hormone called cortisol. Cushing’s disease is a form of Cushing’s syndrome caused by a tumor in the brain’s pituitary gland.
For decades, the standard treatment for an adrenal tumor has been adrenalectomy — a surgery to remove the cancerous adrenal gland. However, this can set the stage for adrenal insufficiency, a condition in which the adrenal glands fail to produce enough of certain hormones.
“Sometimes it is possible, and preferable, to remove the adrenal tumor without removing the entire adrenal gland. This is called partial adrenal surgery,” Tobias Carling, MD, PhD, adrenal surgeon and founder of the Carling Adrenal Center, said in a press release.
“Removing only part of the adrenal gland is a more advanced operation and is typically only performed by expert adrenal surgeons. The goal is to leave some normal adrenal tissue so that the patient can avoid adrenal insufficiency which requires a daily dose of several adrenal hormones and steroids,” Carling said. “Partial adrenal surgery is especially beneficial for patients with pheochromocytoma, as well as Conn’s and Cushing’s syndrome.”
The new procedure involves surgically removing the part of the adrenal gland that houses the tumor first. Then, the remaining portion of the gland is covered with a piece of amniotic membrane — the innermost layer of the placenta that forms during fetal development.
It is thought that the amniotic membrane releases signaling molecules that can promote the growth and healing of the adrenal gland after it has been damaged from surgery, ultimately leading to a faster recovery of adrenal function.
“Our study shows [partial adrenal surgery] is more successful when amniotic membrane is used,” Carling said.
Early data from an ongoing clinical trial indicate this technique leads to fewer patients needing treatment with steroids after adrenal surgery. In those who do require steroid treatment, it is for a markedly shorter period of time.
“Avoiding daily steroids is life-changing for these patients so this is a major breakthrough,” Carling said.
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