[Selection of surgical approach in operations on the adrenal glands]

The problem of the operative access is discussed on the basis of the experience with 237 operations on the adrenals for different pathological conditions. The author proposes the extrapleural-extraperitoneal access through the bed of the resected XI rib as an expedient one in most cases. Thoracophrenolumbotomy in the Xth intercostal space is thought to be expedient for pheochromocytoma (of any size) and great tumors of other nature. The laparotomic access to the adrenals is believed to be less convenient.