Partial laparoscopic adrenalectomy for aldosteronoma: our experience

Abstract

Background: Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. We demonstrated the safety and feasibility of the laparoscopic technique in patients with primary hyperaldosteronism caused by solitary aldosteronoma treated by laparoscopic partial adrenalectomy. Aim: To demonstrate safety and feasibility of laparoscopic partial adrenalectomy in aldosterone-producing adenomas. Materials and methods: From 1992. to the present time, 13 patients presented with hyperaldosteronism and a single adrenal adenoma (Conn’s syndrome) and were treated with laparoscopic partial adrenalectomy. The mean age was 65 years, and the average tumor size was 1.35 cm in diameter. The mean follow-up of our patients for hypertension and local reccurence was 36 months (range 6 – 72 months). A transperitoneal approach was used in all patients, tumors were resected with safety margins by ultrasonic device. Results: All procedures were finished laparoscopically, and no conversion was necessary. The mean duration of the operations was 65 minutes, with a mean bleeding rate of 40 ml. No major intraoperative or postoperative complication was observed. Postoperative mean hospital stay was 4 days. In all the cases, hypertension improved totally or partially, and no local recurrence was observed. Conclusion: Laparoscopic partial adrenalectomy for aldosterone-producing adenomas is a minimally invasive procedure with a low complication rate. This procedure can be performed with good results for patients with small aldosteronomas of the adrenal gland, even with a healthy contralateral adrenal gland.

Keywords

• primary aldosteronism
• laparoscopy
• partial adrenalectomy