EWHA WOMANS UNIVERSITY MOKDONG HOSPITAL

The kidneys are organs located in the retroperitoneum, below the lungs and behind the flanks. height is large.

1. Substance that belongs to the cortex and the cortex

2. Renal calyx, the path through which urine made in the substance comes out

3. It consists of the renal pelvis where urine from the renal vessel joins primarily.

The term kidney cancer usually refers to cancer that originates in the parenchyma. The shape of the tissue is different from that of tumors derived from the renal belly and renal pelvis, and the surgical method is slightly different.

In the past, patients visited the hospital with major symptoms such as hematuria, flank pain, and palpable lumps, but with the recent development of radiology in health checkups, more than 90% of cases are found 'accidentally' before reaching these symptoms. I did it.

The surgical method has also changed compared to the past. In the past, radical nephrectomy, which removes the entire kidney, was performed a lot, but recently, the frequency of partial nephrectomy, which removes only the lump of kidney cancer, is rapidly increasing. This is entirely related to the time when kidney cancer is discovered and the size of the nodule. The sooner it is diagnosed, the greater the possibility of removing the tumor while preserving kidney function.

The location of the tumor is also an important factor in determining the surgical method. Although small in size, if it is adjacent to the renal blood vessels or invades the renal bladder and renal pelvis, the difficulty of partial nephrectomy increases, and partial resection is impossible in some cases. Conversely, partial nephrectomy can be considered even for large tumors if the distance from the renal vessels, renal vessels, and renal pelvis is appropriate. Recent studies have reported that there is no significant difference in recurrence rate and survival rate between radical nephrectomy and partial nephrectomy when the tumor is removed surgically for renal cancer without metastasis. However, partial nephrectomy is not the answer for all kidney cancer. It is most important for a doctor to select a surgical method that considers the size, nature, and location of a new tumor, the possibility of cancer recurrence and metastasis, and the patient's quality of life in the future.

In the case of partial nephrectomy, minimally invasive surgery (robotic surgery) is very effective because the size of the lump that can be taken out of the body is small. Ewha Womans University Urology Institute has been minimizing the loss of kidney function with recent non-ischemic partial nephrectomy, and even when there are multiple lumps that need to be removed in one kidney, such as genetic diseases, only multiple tumors can be safely removed through partial nephrectomy without damaging renal function. . In addition, high-difficulty surgeries such as renal cancer with malignant thrombus present in the vena cava are safely performed.

The adrenal gland is a bilateral organ located in the upper part of both kidneys and is an important organ essential for maintaining body metabolism and life by controlling hormones in our body.

Adrenal gland disease results from excess or insufficient production of adrenal hormones. Most of the patients referred to the Ewha Womans University Urology Institute are patients with excessive production of adrenal hormones due to adrenal tumors, or patients with large tumors without excessive production of hormones.

Adrenal tumor

Adrenal tumors are fairly rare and 90% are benign. Most occur in only one adrenal gland, and the location of the adrenal gland in which the tumor is located determines the nature of the tumor. Most adrenal tumors result in an overproduction of one or more adrenal hormones, which can increase the body's metabolism and affect water retention and response to physical stress, such as trauma.

Recently, the diagnosis of adrenal tumors is increasing due to the increase in ultrasound examinations in health checkups. According to a recent report, adrenal incidentaloma more than doubled, and the size of the tumor showed a decreasing trend. In addition, with the recent development of laparoscopic technology, there has been an overall trend of increasing minimally invasive surgery.

Cushing's Syndrome

In addition to metabolic regulation, corticosteroid hormones are also involved in hydration, salt, and blood pressure regulation. In Cushing's syndrome, overproduction of corticosteroids disrupts this regulation. It affects body fat distribution and body hair, which in turn changes the shape of the body, leading to depression and other psychological problems.

Hyperaldosteronemia

Aldosterone is a hormone produced by the adrenal cortex that affects the kidneys and is responsible for regulating fluids, electrolytes, and blood pressure. A disease in which aldosterone is overproduced in one or both adrenal glands is called hyperaldosteronism, and it causes high blood pressure by increasing salt absorption and potassium excretion through urine. However, the rate that this disease accounts for the cause of high blood pressure is about 1% of all high blood pressure.

Pheochromocytoma (Pheochromocytoma)

The adrenal glands produce epinephrine and norepinephrine in response to normal physical activity or stress. A disease in which these hormones are excessively secreted is pheochromocytoma, which occurs in the adrenal medulla. It is a relatively rare disease, with only about 1/10 being malignant and most being benign tumors. It can occur in multiple endocrine tumors.

At the Adrenal Tumor Center of Ewha Womans University Urology Institute, hormone tests and nuclear medicine tests are performed in consultation with the Endocrinology Department, and minimally invasive surgery is performed when surgery is necessary. Partial adrenal resection is being actively performed.