Endocrine surgery in Niš

Endocrine surgery is the branch of surgery that deals with operations on the endocrine glands. Most often these are the thyroid gland at the front of the neck, the small parathyroid glands next to it, of which there are usually four, and the adrenal glands above the kidneys. These glands produce hormones that affect metabolism, heart function, the level of calcium in the blood and blood pressure. That is why the decision to operate is usually made together with an endocrinologist, based on the examination, an ultrasound or other imaging, hormone tests and, if needed, a cytology result. At Maja Hospital in Niš, endocrine surgery is performed by specialists in general surgery with a particular focus on this field.

Most thyroid abnormalities do not need surgery. They are monitored or treated by an endocrinologist. Surgery is most often considered when the cytology result after a needle biopsy of a nodule indicates cancer or is suspicious, and sometimes also when it is indeterminate. It is also considered when the gland is so enlarged (goitre) that it presses on the windpipe or gullet. For an overactive thyroid (hyperthyroidism), surgery is one of the treatment options, alongside medicines and radioactive iodine, and the choice depends on your test results and what you agree with your doctor. The extent of the operation depends on the findings and the doctor's assessment. One lobe can be removed (lobectomy, also called hemithyroidectomy), or the whole gland (total thyroidectomy). The course of treatment, preparation and recovery are described further down this page.

The parathyroid glands control the level of calcium in the blood. When one or, less often, several of them become overactive, the levels of calcium and parathyroid hormone (PTH) in the blood are raised. The most common cause is a benign (non-cancerous) enlargement of one gland (an adenoma). Over time this can weaken the bones and contribute to the formation of kidney stones. A raised parathyroid hormone level with normal or low calcium usually has a different cause, for example vitamin D deficiency or kidney disease, and in that case it is not usually treated with surgery. When the surgeon and the endocrinologist decide that an operation is needed, an attempt is made before the procedure to locate the enlarged gland with ultrasound and other imaging.

The adrenal glands are usually operated on when a tumour, most often benign, is found on them and produces excess hormones, or when an abnormality is found that needs to be removed because of its size or appearance on a scan. Such an abnormality is often found by chance, on an abdominal scan done for another reason. Before a decision is made, blood and urine hormone tests are done, together with a CT or MRI scan. For some hormone-producing tumours, preparation with medicines is needed before surgery, and this is decided by the endocrinologist and the surgeon.

Maja Hospital is a private hospital at Vizantijski bulevar 39 in Niš. The radiology department and the laboratory are in the same building. A thyroid ultrasound and Doppler scan can be done before or after the consultation with the surgeon, and samples for hormone tests are taken at the laboratory. Before the operation, the patient is seen by an anaesthetist. Thyroid operations are usually done under general anaesthetic. The removed tissue is sent for histopathology (examination of the tissue under a microscope), and the result is explained at the follow-up appointment after the operation. The plan for the operation, including the type of procedure and the length of the hospital stay, is decided by the surgeon after the consultation and a review of all your test results.