[Surgery of the adrenals].

With 131 operated patients in the University Hospital of Urology in Zurich the indication for surgery in the 4 most frequent groups of adrenal disease is discussed. The preoperative localization of the tumor is exact in 96% of all cases with the serum examination in different stage of the vena cava. The appearance of hypertensive and hypotensive crises during surgery can be prevented with an adequate alpha-adrenergic blockade and volume replacement before and during the operation. In the surgery of Morbus Cushing we prefer the bilateral, dorsal incision on the 11th rib, if we haven't an unilateral adenoma. In the cases of Conn disease the removal of the whole surroundings of the adrenal gland is additionally indicated. The prognosis of the carcinoma of surrenal glands is poor, the adrenalectomy is difficult with regard to the early infiltration, the illness is seldom stopped on account of the frequent metastatic formation.