Laparoscopic simultaneous bilateral adrenalectomy for patients with bilateral aldosterone-producing (micro)adenoma: Assessment of feasibility and potential indication

点击翻译按钮获取中文摘要

We evaluated the feasibility and outcomes of laparoscopic adrenalectomy (LA) for patients with unilateral/bilateral aldosterone-producing adenomas. All patients with primary aldosteronism (PA) were conducted adrenal venous sampling and were decided hyper-secreting side(s). (1)A total of 174 cases with unilateral PA received unilateral total LA. All procedures were safely performed. Nearly one fourth of them were aldosterone-producing microadenoma. Plasma aldosterone concentration and anti-hypertensive drugs were significantly decreased after surgery (p<0.01, p<0.05). Hypertension was cured/improved in 89.1% of patients. (2) A total of 45 patients with bilateral adrenal disease (including 29 cases of bilateral PA) were performed simultaneous bilateral LA. All procedures were also safely accomplished without adrenal insufficiency. Patients undergoing adrenal-sparing bilateral LA required glucocorticoid replacement; however, all discontinued within 24 months. Either unilateral or bilateral LA was safely performed. These procedures for patients with unilateral/bilateral PA couldbring about satisfied surgical and endocrinological outcomes.