45 NOT ALL PATIENTS WITH UNILATERAL PRIMARY ALDOSTERONISIM OBTAIN ANTI-HYPERTENSIVE EFFECT AFTER LAPAROSCOPIC ADRENALECTOMY

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You have accessJournal of UrologyAdrenal: Surgery + Tumors/Benign and Malignant Disease (Physiology and Pharmacology)1 Apr 201245 NOT ALL PATIENTS WITH UNILATERAL PRIMARY ALDOSTERONISIM OBTAIN ANTI-HYPERTENSIVE EFFECT AFTER LAPAROSCOPIC ADRENALECTOMY Noritaka Kamimura, Yusuke Ishibashi, Yoko Murasawa, Yuichiro Suzuki, Hirofumi Ishimura, Shingo Hatakeyama, Shigemasa Kudo, Takahiro Yoneyama, Takuya Koie, Yuki Tobisawa, Toru Yoneyama, Kazuyuki Mori, and Chikara Ohyama Noritaka KamimuraNoritaka Kamimura Hirosaki, Japan More articles by this author , Yusuke IshibashiYusuke Ishibashi Hirosaki, Japan More articles by this author , Yoko MurasawaYoko Murasawa Hirosaki, Japan More articles by this author , Yuichiro SuzukiYuichiro Suzuki Hirosaki, Japan More articles by this author , Hirofumi IshimuraHirofumi Ishimura Hirosaki, Japan More articles by this author , Shingo HatakeyamaShingo Hatakeyama Hirosaki, Japan More articles by this author , Shigemasa KudoShigemasa Kudo Hirosaki, Japan More articles by this author , Takahiro YoneyamaTakahiro Yoneyama Hirosaki, Japan More articles by this author , Takuya KoieTakuya Koie Hirosaki, Japan More articles by this author , Yuki TobisawaYuki Tobisawa Hirosaki, Japan More articles by this author , Toru YoneyamaToru Yoneyama Hirosaki, Japan More articles by this author , Kazuyuki MoriKazuyuki Mori Hirosaki, Japan More articles by this author , and Chikara OhyamaChikara Ohyama Hirosaki, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.089AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic adrenalectomy (LA) has already established as standard treatment of primary aldosteronisim (PA). However, blood pressure outcome is not documented enough. The aim of the present study was to assess blood pressure outcome of LA for the patients with unilateral (PA). METHODS Between Apr. 2000 and Sep. 2010, we performed consecutive 56 LAs for the unilateral PA. Mean ages were 55.6 years old, males 25 cases, females 31 cases. The average morbidity duration of hypertension was 12.6 years. The diagnosis of PA and responsible laterality was determined by adrenal venous sampling and CT. The pre-operative blood pressure was defined the 3 days average before operation in the sitting position after breakfast. The post-operative pressure was measured under the same condition 3 weeks and 1 year after operation. We scored the amount of anti-hypertensive. &undefined;@ Outcome variables were post-operative serum potassium and aldosterone levels, number of hypertensive medications, and mean arterial blood pressure at 6 months. We scored the hypertensive medications according to amount and kind of the agent based on our original scoring system. RESULTS Post-operative serum potassium and aldosterone levels were normalized in all patients after the LA. The pre-operative systolic and diastolic blood pressure was 141 &undefined;}19mmHg, 80 &undefined;};9mmHg, respectively. The post-operative systolic and diastolic blood pressure was 126 &undefined;}18mmHg, 76 &undefined;};8 mmHg, respectively, which showed significant improvement. The hypertensive medication score improved from 2.3 &undefined;}1.7 to 1.1 &undefined;}1.7. Of 22 cases whose blood pressure was measurable 1 year after the surgery, four cases (18%) had no improvement of hypertension. CONCLUSIONS Laparoscopic adrenalectomy improved blood pressure and the demands of hypertensive medications. However, a considerable number of patients (18%) remained hypertensive in spite of the normalized serum aldosterone . Further investigations will be required to identify the patients who obtain favorable blood pressure outcome from laparoscopic adrenalectomy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e19 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noritaka Kamimura Hirosaki, Japan More articles by this author Yusuke Ishibashi Hirosaki, Japan More articles by this author Yoko Murasawa Hirosaki, Japan More articles by this author Yuichiro Suzuki Hirosaki, Japan More articles by this author Hirofumi Ishimura Hirosaki, Japan More articles by this author Shingo Hatakeyama Hirosaki, Japan More articles by this author Shigemasa Kudo Hirosaki, Japan More articles by this author Takahiro Yoneyama Hirosaki, Japan More articles by this author Takuya Koie Hirosaki, Japan More articles by this author Yuki Tobisawa Hirosaki, Japan More articles by this author Toru Yoneyama Hirosaki, Japan More articles by this author Kazuyuki Mori Hirosaki, Japan More articles by this author Chikara Ohyama Hirosaki, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...