Clinical outcomes in patients undergoing laparoscopic adrenalectomy for unilateral aldosterone producing adenoma: partial versus total adrenalectomy.

Abstract

Laparoscopic adrenalectomy is the standard treatment for patients with aldosterone producing adenoma (APA). Tthe comparative effectiveness between laparoscopic total and partial adrenalectomy remains controversial, however. In this study, we compared the clinical outcomes for the two procedures. We analyzed the patients with unilateral APA undergoing laparoscopic total or partial adrenalectomy during the period 2008 to 2011. All surgical procedures were performed transperitoneally. We compared the perioperative and postoperative parameters between two procedures. Clinical outcomes including serum aldosterone, renin, and potassium levels, and systolic and diastolic blood pressure (DBP) were assessed and compared at 1 year after operation. A total of 63 cases (16 partial and 47 total adrenalectomies) were included. There were no differences with regard to age, sex, hypertension duration, and tumor size as well as preoperative blood pressure, serum aldosterone, rennin, and potassium levels between the two groups. The perioperative and postoperative outcomes such as operative time, hospital stay, blood loss, and complications were similar between the two groups. The clinical outcomes at 1-year follow-up including serum aldosterone, renin, and potassium levels and blood pressure significantly improved in both groups. Laparoscopic partial adrenalectomy is technically feasible and yields similar perioperative, postoperative, and 1-year clinical outcomes to those of total adrenalectomy for the treatment of patients with unilateral APA. A prospective randomized study with a larger sample size is needed to further prove the cost and effectiveness of the two procedures.