adrenal cystectomy

Adrenal cysts can be detected by oppression of the tumor, and can be displayed asymptomatically by imaging examination. The small ones are only a few millimeters, and the larger ones can reach 30cm in diameter. According to the pathological nature, they can be divided into: 1 parasitic nature: found in echinococcosis infection. The outer wall thickness of the cyst can be calcified. There are ascus and sun sacs in the sac, which are called adrenal hydatid cysts. 2 Epithelial: the inner wall is columnar epithelial lining, which is abnormally developed from the embryonic primordial part; 3 : For the common type, according to the tissue components, lymphatic and vascular, the former is more common; 4 pseudocyst: formed after adrenal hemorrhage or tumor necrosis, large cyst, wall-free cell lining, Treatment of diseases: Adrenal tumors adrenal gland tumors Indication Adrenal cystectomy is available for: 1. There are symptoms of tumor compression, cyst diameter > 5cm are all indications for surgical treatment. 2. Hydatid cysts and neoplastic cysts are diagnosed and treated early. 3. Asymptomatic, simple cysts <4cm in diameter, can continue to observe clinically, increase, and re-operation after symptoms. Preoperative preparation Preoperative preparation for general adrenal surgery. Surgical procedure A lumbar incision or abdominal incision path exposes the adrenal gland. According to the pathology of the cyst, the surgical method is different. 1. Simple cysts have a complete capsule, only the cyst can be removed, leaving the normal adrenal gland. The method is the same as adenoma removal. 2. Tumor cysts, adrenal gland lesions are extensive, feasible adrenal gland, cyst resection. 3. Hydatid cysts, after tightly protecting the surrounding tissue, first puncture diagnosis, after sucking out a certain amount of hydatid cyst fluid, inject 4% formalin, after killing the inner segment of the capsule, cut the outer capsule, clear the ascus, grandchild The capsule is then wiped with the formaldehyde liquid gauze ball to wipe the inner wall of the outer capsule, and then most of the outer capsule wall is cut off, and the residual cavity is closed from the bottom to the outer layer, and the outer wall opening is sutured. A rubber tube is placed in the surgical field for drainage. 4. Hemorrhagic pseudocyst is much larger. First, the cystic fluid is aspirated, decompressed, and then peeled off from the surrounding organs. When the separation is impossible, the free capsule wall is mostly removed. The residual wall edge of the capsule is sutured with a 3-0 absorbable line to achieve complete hemostasis and completely expose the bottom of the capsule without causing cyst recurrence. If the old body is debilitated or the heart or brain is sick, if the surgery cannot be performed, for simple cysts, puncture and aspiration can be performed under the monitoring of B-mode ultrasound or TV screen. The aspirate fluid is sent to the biochemical and tumor cells for detection. After the cystic fluid is absorbed, the contrast agent is injected. If the inner wall is smooth, the tumor cyst can be removed, and an appropriate amount of the hardener can be injected. Long-term follow-up observation after aspiration.