Partial laparoscopic adrenalectomy in primary hyperaldosteronism

Abstract

Introduction: Primary hyperaldosteronism is one of the few potentially curable causes of secondary arterial hypertension. One of the most important variants is the adenoma of the adrenal cortex that produces aldosterona (Conn’s Syndrome). The treatment of choice in this subgroup of patients was the removal of the lesion. A first series of aldosteronoma-carrying patients subjected to partial laparoscopic adrenalectomy is presented. Materials and method: We examined the case selection and methods applied to hypertensive patients subjected to partial laparoscopic adrenalectomy between November 2001 and March 2004 due to primary hyperaldosteronism. They all presented an imaging study (CT scan) compatible with a tumour of the adrenal cortex; in two patients the lesion was bilateral. One patient had a history of incidental adrenalectomy during an open colecistectomy performed some years previously. Results: We operated on 16 patients, 13 of them women and 3 men, with a mean age of 55.4 years. We performed 18 laparoscopic adrenalectomies: 17 conservative operations and one total adrenalectomy of a 4.3 cm tumour in a patient with bilateral lesion. The mean duration of the operations was 70.9 minutes, with a mean bleeding rate of 30 ml. There were no complications or the need to resort to open surgery. Postoperative hospital stay was 2.8 days. In all the cases, the hypertension improved totally or partially. Conclusion: Although small, the series confirmed that partial laparoscopic suprarenalectomy can be performed with good results and with the advantages of minimally invasive surgery.