[The choice of operative intervention in combined treatment of malignant tumors of the adrenal glands].

Comparative efficacy of various kinds of surgical treatment for malignant tumors of adrenal glands (MTAG) was studied. Traumaticity of various kinds of operations was estimated. There were operated on 318 patients, suffering MTAG: in 280--primary interventions were performed and in 38--reoperations. An optimal surgical intervention constitutes the adrenal gland excision en bloc with the tumor and performance of systemic lymph nodes dissection (LND) of paranephral, paraaortal (left--sided) and paracaval (right-sided) collectors. Adrenalectomy (AE) with LND of retroperitoneal space is the operation of choice in the MTAG treatment. Performance of AE with the tumor excision en bloc with LND, foreseeing high efficacy of the treatment, is possible in I-II stages of tumor only, when its malignant character could not be confirmed pre- or intraoperatively.