Laparoscopic Management of Primary Hyperaldosteronism: Clinical Experience with 212 Cases

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2003Laparoscopic Management of Primary Hyperaldosteronism: Clinical Experience with 212 Cases PAUL MERIA, BÉATRICE FIQUET KEMPF, JEAN FRANÇOIS HERMIEU, PIERRE FRANÇOIS PLOUIN, and JEAN MARC DUCLOS PAUL MERIAPAUL MERIA , BÉATRICE FIQUET KEMPFBÉATRICE FIQUET KEMPF , JEAN FRANÇOIS HERMIEUJEAN FRANÇOIS HERMIEU , PIERRE FRANÇOIS PLOUINPIERRE FRANÇOIS PLOUIN , and JEAN MARC DUCLOSJEAN MARC DUCLOS View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64028-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Laparoscopy is now widely used to remove benign adrenal tumors. We assessed the value of transperitoneal partial or total adrenalectomy for primary hyperaldosteronism. Materials and Methods: From September 1994 to October 2001, 212 consecutive patients with a mean age of 48 years who presented with primary hyperaldosteronism and related arterial hypertension underwent transperitoneal laparoscopic adrenalectomy (193) or tumor enucleation (20) performed by a single surgeon, including 1 who underwent bilateral adrenalectomy. In all cases preoperatively high plasma and urine aldosterone was associated with low plasma renin and hypokalemia. Results: Mean followup was 44 months. Conversion to open surgery was necessary in 30 patients (14%) due to bleeding or adhesion and a procedure duration of greater than 3 hours. Mean operative time was 102 minutes (range 30 to 260). Six patients (2.8%) required blood transfusion. No deaths occurred. Postoperatively complications were observed in 10% of patients and the most frequent one was electrical myocardial ischemia without infarction. Mean postoperative pain medication was 17 mg. morphine sulfate equivalents (range 0 to 60). Mean and median hospital stay was 3.6 and 2.9 days, respectively (range 2 to 20). Postoperatively blood pressure was normal in 58% of patients without any drug, while treatment was decreased in the remainder. Kalemia was normalized in all cases. Conclusions: Although some complications can occur, mostly at the beginning of the learning curve, laparoscopic transperitoneal adrenalectomy is effective treatment for primary hyperaldosteronism. References 1 : Primary aldosteronism, a new clinical syndrome. J Lab Clin Med1955; 45: 3. Google Scholar 2 : Hypertension and primary hyperaldosteronism. Arch Mal Coeur Vaiss2000; 93: 1469. Google Scholar 3 : Anaesthesia for Conn's syndrome. Anaesthesia1999; 54: 569. Google Scholar 4 : Laparoscopic adrenalectomy versus medical management for aldosteroma. J Urol2002; 167: 22. abstract 90. 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Abstract, Google Scholar From the Department of Urology, St-Joseph Hospital and Department of Arterial Hypertension, Georges Pompidou's European Hospital of Paris, Paris, France© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byFu B, Zhang X, Wang G, Lang B, Ma X, Li H, Wang B, Shi T, Ai X, Zhou H and Zheng T (2018) Long-Term Results of a Prospective, Randomized Trial Comparing Retroperitoneoscopic Partial Versus Total Adrenalectomy for Aldosterone Producing AdenomaJournal of Urology, VOL. 185, NO. 5, (1578-1582), Online publication date: 1-May-2011.Kaye D, Storey B, Pacak K, Pinto P, Linehan W and Bratslavsky G (2018) Partial Adrenalectomy: Underused First Line Therapy for Small Adrenal TumorsJournal of Urology, VOL. 184, NO. 1, (18-25), Online publication date: 1-Jul-2010.ISHIDOYA S, ITO A, SAKAI K, SATOH M, CHIBA Y, SATO F and ARAI Y (2018) LAPAROSCOPIC PARTIAL VERSUS TOTAL ADRENALECTOMY FOR ALDOSTERONE PRODUCING ADENOMAJournal of Urology, VOL. 174, NO. 1, (40-43), Online publication date: 1-Jul-2005. Volume 169Issue 1January 2003Page: 32-35 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordslaparoscopyadrenalectomyadrenal glandshyperaldosteronismMetricsAuthor Information PAUL MERIA More articles by this author BÉATRICE FIQUET KEMPF More articles by this author JEAN FRANÇOIS HERMIEU More articles by this author PIERRE FRANÇOIS PLOUIN More articles by this author JEAN MARC DUCLOS More articles by this author Expand All Advertisement PDF downloadLoading ...