Document Detail


Radiofrequency ablation for benign aldosterone-producing adenoma: a scarless technique to an old disease.
MedLine Citation:
PMID:  21107117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and efficacy of radiofrequency ablation (RFA) in treating primary aldosteronism (PA) due to aldosterone-producing adenoma (APA).
BACKGROUND: Radiofrequency ablation is an established technique for treating malignant solid organ neoplasm. Its application on benign functional adrenal adenoma has never been prospectively described.
METHODS: We prospectively evaluated a patient cohort with computed tomography (CT)-guided percutaneous RFA performed on functional APA of size 4 cm or less. Treatment success was defined as complete tumor ablation on follow-up CT scan plus normalization of serum aldosterone-to-renin ratio (ARR) at 3 to 6 months after RFA. Salvage laparoscopic adrenalectomy was offered to patients who had failed RFA and remained hypertensive.
RESULTS: Between August 2004 and August 2008, 28 patients were referred for the procedure. Radiofrequency ablation was not performed on 4 APA because of their close proximity to major vascular structures. Twenty-four patients (11 men and 13 women) with a median age of 51.5 (range = 34-63) years underwent RFA for 11 right and 13 left APA. The median tumor diameter was 16.0 (range = 4.0-25.0) mm. There was no periprocedure hypertensive crisis or major morbidity or mortality. Minor complications occurred in 4 patients (16.7%), including 1 small pneumothorax and 3 retroperitoneal hematomas (< 3 cm), which all resolved on conservative treatment. At 3 to 6 months of follow-up, CT scan showed complete tumor ablation in all patients (100%). Primary aldosteronism was biochemically resolved in 23 patients (95.8%). Salvage adrenalectomy was not performed in the single failed patient, as she remained normotensive on repeated follow-up. The overall success rate of RFA was 95.8%.
CONCLUSIONS: Computed tomography-guided percutaneous RFA is a safe and efficacious alternative to laparoscopic adrenalectomy in treating patients with PA due to small APA.
Authors:
Shirley Yuk-Wah Liu; Enders Kwok-Wai Ng; Paul Sing-Fun Lee; Simon Kin-Hung Wong; Philip Wai-Yan Chiu; Wilfred Lik-Man Mui; Wing-Yee So; Francis Chun-Chung Chow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  252     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  2010-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1058-64     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  surgery*
Adrenal Gland Neoplasms / complications,  surgery*
Adult
Catheter Ablation*
Cohort Studies
Female
Humans
Hyperaldosteronism / etiology*
Male
Middle Aged
Prospective Studies
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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