THE ADVISIBILITY OF ADRENALECTOMY IN THE RADICAL NEPHRECTOMY FOLLOWING THE NEPHROMA
Article published in Urologia Polska 1988/41/1.
Jan Szymanowski, Zofia Kasprzycka, Maria Barbara Gabryelewicz, Ewa Koźmińska
- Z Oddziału Urologii Szpitala Bielańskiego w Warszawie
Ordynator: dr n. med. J. Szymanowski
Z Zakładu Diagnostyki Patomorfologiczne] CMKP w Warszawie Kierownik: prof. dr hab. med. M. Kobuszewska-Faryna
- In the renal carcinoma there may also be some changes within the adrenal gland adjoining the focus of the neoplasm, therefore radical nephrectomy should be combined with adrenalectomy.
- A group of 98 patients having had radical nephrectomy because of the nephroma has been examined. In 19 of them (19,38%) microscopic analysis revealed a disease process in the removed adrenal gland. In 12 patients (12,24%) the changes were caused by the renal carcinoma (in 7 cases they were metastasis and in five ? direct malignant infiltration). In the remaining seven patients the changes were found to be mild. Metastasis to the other adrenal gland was the cause of death in the post-operative process in as many as thres patients.
- The conclusions is that the radical nephrectomy in patients with renal carcinoma one should also remove the adrenal gland. Before the operation it is ad-visable to perform dose examinations of the adrenal glands, if possible by means of Computer tomography, ultrasonography, arteriography, and it is necessary to state the level of sterids in the serum and urine.
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