| Single-center Outcome of Laparoscopic Unilateral Adrenalectomy for Patients With Primary Aldosteronism: Lateralizing Disease Using Results of Adrenal Venous Sampling. | |
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MedLine Citation:
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PMID: 21334048 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To assess the clinical effect of the universal use of adrenal venous sampling and to investigate the characteristics of patients with primary aldosteronism undergoing laparoscopic adrenalectomy at a single tertiary care center. METHODS: After the screening examination, confirmatory test, and computed tomography (CT) scans were completed, all patients with biochemically diagnosed hyperaldosteronism underwent adrenal venous sampling to differentiate unilateral disease from bilateral idiopathic hyperaldosteronism. A total of 174 consecutive patients with unilateral aldosterone excess underwent unilateral laparoscopic adrenalectomy. RESULTS: The surgically treated cohort was divided into 3 groups according to the CT findings. A total of 129 patients (74.1%) had findings associated with CT-positive macroadenoma (type 1A) and 42 (24.1%) with CT-negative microadenoma (type 2A). Only 3 patients (1.8%) had adrenocortical hyperplasia (type 3). The aldosterone level was normalized in all but 2 patients (98.9%), and the number of antihypertensive agents was significantly reduced within 1 month after adrenalectomy. Of the 174 patients, 155 (89.1%) showed resolution or improvement of hypertension. CONCLUSIONS: The routine use of adrenal venous sampling could adequately detect lateralization in patients with unilateral aldosterone excess, which led to satisfactory short-term outcomes after surgery. The results of the present study showed that nearly one fourth of patients with the unilateral form had a CT-negative aldosterone-producing microadenoma. |
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Authors:
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Shigeto Ishidoya; Yasuhiro Kaiho; Akihiro Ito; Ryo Morimoto; Fumitoshi Satoh; Sadayoshi Ito; Tadashi Ishibashi; Yasuhiro Nakamura; Hironobu Sasano; Yoichi Arai |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-17 |
Journal Detail:
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Title: Urology Volume: - ISSN: 1527-9995 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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