Why the study?
Differences between perioperative and functional outcomes in patients undergoing minimally-invasive partial versus total adrenalectomy for unilateral primary aldosteronism required assessment.
Does minimally-invasive partial adrenalectomy improve perioperative and functional outcomes compared to minimally-invasive total adrenalectomy in patients with unilateral primary aldosteronism?
Does minimally-invasive partial adrenalectomy improve perioperative and functional outcomes compared to minimally-invasive total adrenalectomy in patients with unilateral primary aldosteronism?
Minimally invasive partial and total adrenalectomy provide comparable perioperative and functional outcomes for unilateral primary aldosteronism, though partial adrenalectomy is typically reserved for specific patient subsets.
BACKGROUND: This systematic review and metanalysis was conducted to assess differences between perioperative and functional outcomes in patients undergoing minimally-invasive partial (mi-PA) and total adrenalectomy (mi-TA) for unilateral primary aldosteronism (uPHA). MATERIAL AND METHODS: Multiple scientific databases (PUBMED, Web of Science, and Cochrane Library) were searched up to November 2021 for surgical series comparing mi-PA vs. mi-TA for uPHA according to the PRISMA statement. Primary outcomes of interest were perioperative and functional outcomes. RESULTS: = 478) of cases, respectively. No differences were recorded between the two groups according to number of transfusions, EBL and Clavien-Dindo complications ≥2. Similarly, no differences in clinical success, persistence of postoperative hypokalemia and improvement in HTN were reported between mi-PA and mi-TA. CONCLUSIONS: In a uPHA setting, mi-PA and mi-TA provide comparable perioperative and functional outcomes despite the use of mi-PA remains limited to patients with small adenoma size, or hereditary/bilateral disease. Due to limited use of standardized reporting criteria in most of current series, the quest for a superiority of mi-PA over mi-TA in the treatment of uPHA still remains open.
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Flammia et al. (2022) studied this question.
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