Endocrine Surgery

Lesson Objectives

By the end of this topic, learners should be able to:

1. Identify common endocrine surgical conditions and indications for surgery.

2. Understand pathophysiology and clinical features of endocrine disorders.

3. Recognize post-operative complications and nursing priorities.

4. Apply medical and nursing principles to optimize endocrine surgical outcomes.

 Key Glossary Terms

1. Thyroidectomy

• Definition: Surgical removal of part or all of the thyroid gland.

• Indications: Thyroid cancer, large goiter causing compressive symptoms, hyperthyroidism refractory to medical therapy

• Post-Op Considerations: Monitor airway, bleeding/hematoma, hypocalcemia (if parathyroids affected), voice changes

2. Parathyroid Surgery

• Definition: Removal of hyperfunctioning parathyroid glands.

• Indications: Primary hyperparathyroidism, parathyroid adenoma, hyperplasia

• Complications: Hypocalcemia (tetany), recurrent laryngeal nerve injury, hematoma

3. Adrenalectomy

• Definition: Surgical removal of one or both adrenal glands.

• Indications: Pheochromocytoma, adrenal carcinoma, Conn’s syndrome, Cushing’s syndrome

• Post-Op Considerations: Monitor blood pressure, fluid/electrolytes, adrenal insufficiency, infection

4. Pancreatic Surgery

• Definition: Surgical interventions on the pancreas, including distal pancreatectomy, Whipple procedure

• Indications: Pancreatic tumors, chronic pancreatitis, insulinomas

• Post-Op Considerations: Monitor glucose, pancreatic enzyme supplementation, infection prevention, nutritional support

5. Hypocalcemia

• Definition: Low serum calcium, often post-parathyroid or thyroid surgery

• Clinical Features: Paresthesia, tetany, Chvostek’s sign, Trousseau’s sign

• Management: Calcium gluconate IV, oral calcium, vitamin D supplementation

6. Thyroid Storm

• Definition: Life-threatening exacerbation of hyperthyroidism

• Clinical Features: Fever, tachycardia, hypertension, altered mental status

• Management: Beta-blockers, antithyroid drugs, supportive care

7. Nursing & Medical Student Focus

• Nursing: Monitor vital signs, airway, calcium levels, wound care, pain management, patient education on hormone therapy

• Medical Students: Identify surgical indications, understand anatomy of thyroid/parathyroid/adrenal glands, monitor for complications, interpret lab results

8. Endocrine Surgery Mnemonics

• “HYPER” for hyperparathyroidism features:

  • Hypercalcemia

  • Yawning / fatigue

  • Polyuria

  • Elevated PTH

  • Renal stones

• “THYROID” for post-thyroidectomy complications:

  • Tetany (hypocalcemia)

  • Hematoma / hemorrhage

  • Yellow skin (rare)

  • Recurrent laryngeal nerve injury

  • Outflow obstruction (airway)

  • Infection

  • Dysphagia

 Tables

Table 1: Common Endocrine Surgical Conditions

Table 2: Post-Operative Nursing Care in Endocrine Surgery