Short- and long-term results of laparoscopic adrenalectomy for Conn's syndrome release_al5zqxqjangujdkgnfaqcmzek4

by Mateusz Wierdak, Grzegorz Sokołowski, Michał Natkaniec, Karolina Morawiec-Sławek, Piotr Małczak, Piotr Major, Alicja Hubalewska-Dydejczyk, Andrzej Budzyński, Michał Pędziwiatr

Published in Videosurgery and Other Miniinvasive Techniques by Termedia Sp. z.o.o..

2018   Volume 13, Issue 3, p292-298

Abstract

The primary treatment of Conn's syndrome (CS) is laparoscopic adrenalectomy and aims to normalize arterial blood pressure and biochemical parameters. To analyse short- and long-term results of laparoscopic adrenalectomy for Conn's syndrome (CS). The analysis included 44 consecutive patients, who underwent laparoscopic adrenalectomy between 2004 and 2015 for CS. We analysed short- and long-terms results of operations. All patients were followed up 6 and 24 months after surgery to determine changes in the biochemical parameters, and clinical regression of arterial hypertension. We also evaluated the aldosteronoma resolution score (ARS) in predicting the resolution of hypertension. No conversions were needed. Complications occurred in 5 (11.4%) patients. Preoperative hypokalaemia and hypernatraemia were present in 83.4% and 15.8% of patients, respectively. After surgery, both hypokalaemia and hypernatraemia resolved in all patients. At the follow-up 6 months after the surgery, only 11.3% of patients had complete remission (CR) of hypertension. In 43.2% of cases we observed partial remission (PR). After 24 months CR was found in 13.6% of patients, 45.5% patients fulfilled criteria for PR, and 29.5% of patients changed the group of remission comparison to the first follow-up visit. Only 50% of patients with an ARS of 4 or 5 points achieved CR 6 months after surgery. Laparoscopic adrenalectomy is a safe method of treatment for CS. Although it effectively eliminates electrolyte imbalance, it does not allow for the CR of hypertension in the majority of patients, especially in the elderly group. We did not find ARS to be an effective tool in predicting postoperative resolution of hypertension.
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