Retroperitoneai laparoscopic partial adrenalectomy for the treatment of primary hyperaidosteronism with adrenal adenoma
- VernacularTitle:后腹腔镜下保留肾上腺手术治疗腺瘤型原发性醛固酮增多症
- Author:
Qing YANG
;
Hanzhong LI
- Publication Type:Journal Article
- Keywords:
Hyperaldosteronism;
Adrenocortical adenoma;
Laparoscopes
- From:
Chinese Journal of Urology
2008;(11):736-739
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical application of retroperitoneal laparoscopic adrenal gland sparing adrenalectomy in the treatment of primary hyperaldosteronism with adrenal adenoma. Methods From 2001 to 2006, clinical data of 196 primary hyperaldosteronism with adrenal adenoma patients (78 males and 118 females with mean age of 41±12, ranging 16-69 years old) confirmed during operation were retrospectively analyzed. All cases were with preoperatively high plasma aldo-sterone, low plasma renin, hypokalemia and arterial hypertension. Results Retroperitoneal laparo-scopic adrenalectomy were successfully completed in all cases. No major complication occurred. of them, partial adrenaleetomies were performed in 51 cases and enucleationa of adrenal adenoma were performed in 145 cases. The operative time was ranged from 15 to 87 min (MD=33 min) and the esti-mated blood loss was ranged from 5 to 200 ml (MD=20 ml). There was no case accepted transfusion. The length of hospital stay was ranged from 2 to 5 d (mean 2.7±1.3 d). All the 196 cases were fol-lowed up with the range from 6 months to 3 years (mean, 1.8 years). Postoperatively, kalemia was normalized in all cases, blood pressure was normalized in 168 cases (85.7%). The abnormal blood pressure cases were under control with anti-hypertension drugs. The CT scan showed adrenal glands were normal. Serum test showed normal hormonal levels. The serum potassium levels were in normal range in all cases. One cases with abnormal post-operative blood pressure had accepted second surgery to remove the adrenal adenoma and the blood pressure turned to be in normal range afterwards. Con-clusion Retroperitoneal laparoscopic adrenal gland sparing adrenalectomy is a safe and feasible tech-nique and is the first choice in the management of primary hyperaldosteronism with adrenal adenoma.
