I. Where are the adrenal glands? The adrenal glands are on the inner side above the two kidneys The adrenal glands are a pair of important endocrine glands, one above each of the left and right kidneys, distributed on both sides of the first lumbar vertebrae, equivalent to the horizontal position of the eleventh rib of a person, and slightly higher on the right side. The adrenal glands are usually not moved with respiratory movements because of the fixation of the fat capsule around them. Most patients with adrenal tumors have no obvious clinical symptoms and are only discovered during physical examination or unintentional examination, the size of the masses varies, mostly unilateral, and the incidence is similar in men and women. What is the use of adrenal gland? The adrenal gland is a very important endocrine organ, which is divided into two parts: the medulla and the cortex. The medulla mainly produces adrenaline and norepinephrine, which can control the blood pressure and heartbeat of the human body. The adrenal cortex mainly produces three major hormones: 1. glucocorticoids: control the body’s sugar and energy metabolism, as well as anti-inflammatory and anti-allergic effects; 2. salt corticoids: the hormone is called salt corticoids because it controls the metabolism of water and salt in the body; 3. sex hormones: the adrenal cortex can also produce a small amount of gonadal hormones, namely androgens and estrogens. What are the diseases of the adrenal glands? There are many kinds of diseases of the adrenal glands, which can be divided into malignant tumors and benign diseases, but clinically they are generally divided into functional and non-functional nodules according to whether the tumor has a secretory function or not. (a) Functional nodules, commonly divided into three kinds: 1. Cortisolism: It is due to long-term, excessive secretion of cortisol (glucocorticoid) by the adrenal cortex, which causes a series of clinical symptoms, such as centripetal obesity, hypertension, secondary diabetes, muscle atrophy, hirsutism, menstrual disorders or secondary amenorrhea, sexual dysfunction, purple skin lines, full moon face, osteoporosis, pathological fracture, acne, pigmentation, edema, headache, and non-healing wounds. In children, weight gain and growth retardation are common. Adrenocortical carcinoma should be suspected in adults with feminization or masculinization of the male gland. 2.Primary aldosteronism: It is a series of manifestations due to the change of adrenal salt corticosteroid, which leads to the imbalance of human salt and level, and the typical clinical manifestations are high blood pressure and low blood potassium. These people often take oral potassium salt supplementation drugs still can not be controlled, long-term low potassium can lead to human weakness, limb weakness, can not work, etc. Adrenal pheochromocytoma: This is a tumor that occurs in the medulla of the adrenal gland, which produces a large amount of adrenaline in the blood, thus causing a fluctuating increase in blood pressure. The fluctuation range is very large, the highest can exceed 200mmHg, and low blood pressure can occur at low times, so the disease is more dangerous, easy to induce cerebrovascular accidents and even lead to the possibility of death. (b) Non-functional nodules. Many adrenal masses found on clinical examination, including adrenal medullary hyperplasia, cysts, and medullary lipomas, usually do not have any clinical symptoms and are only detected when doing examinations. All indicators of the adrenal gland on laboratory tests in these patients are within the normal range. Although these nodules have no function, they still have compression symptoms when they are large in size, and the possibility of malignant tumor cannot be excluded. How to treat adrenal tumor? When a tumor is found on the adrenal gland, there is no need to be overly nervous because most of these tumors are benign. At this time, we need to combine the patient’s clinical performance and the results of various indicators of the adrenal gland in the laboratory report to make a comprehensive assessment. If it is a non-functional tumor and the size of the tumor is small (less than 2cm), we can consider close follow-up and observation first, and then consider surgical resection if the tumor has a tendency to increase. However, if the size of non-functional tumor is large or if it is not possible to determine whether it is malignant or not, surgery is still recommended. Currently, the gold standard of surgical treatment for adrenal tumor is laparoscopic adrenal tumor resection. The procedure is minimally invasive and has the advantages of small skin incision and no muscle dissection, so the patient has less trauma, faster recovery, less postoperative pain and high patient satisfaction. And the laparoscope used in the operation has the function of magnifying the surgical field, so that there is less vascular damage, complete hemostasis and minimal bleeding during the operation. Of course, for functional adrenal tumors, a period of preparation is required before the surgery is performed. Generally, oral administration of specified antihypertensive drugs is required for more than 2 weeks, and blood pressure and pulse rate are tested to keep them within a certain range and expanded by rehydration in the days before the surgery, thus reducing the fluctuating changes in blood pressure during the surgery and minimizing the risk of surgery.