Surgical outcomes following laparoscopic adrenalectomy for treatment of Conn's syndrome (primary hyperaldosteronism) between 1999 and 2006

Abstract

Background: Primary hyperaldosteronism is a recognised cause of secondary hypertension with its aetiology most commonly due to a secreting aldosterone adenoma of the adrenal gland. Laparoscopic resection of the adrenal tumour has now become the accepted form of intervention. The aim of this study was to assess the effectiveness of such procedures performed by one surgeon over a 7-year period.

Method: An observational study was conducted in respect of 33 patients who underwent adrenalectomies for primary hyperaldosteronism between 1999-2006. Information on blood pressure, electrolytes, medications, histology, patient characteristics and patients' perception of benefit was gathered via clinical notes and a patient questionnaire.

Results: 33 patients were reviewed. The mean follow-up was 38.4 months. Blood pressure and number of medications all had statistically significant decreases. Systolic blood pressure decreased from 146 mmHg preoperatively to 130 mmHg at final follow-up (p<0.00005). Diastolic blood pressure decreased from 91.0 mmHg preoperatively to 81.5 mmHg (p<0.00005). There was also a significant decrease in number of blood pressure medications from 2.3 preoperatively to 1.0 on average (p<0.00005). Only one patient required potassium at final review. Overall 36% had clinical cure and 50% had significant improvement in terms of blood pressure and medications requirements.

Conclusion: The results suggest unilateral laparoscopic adrenalectomy is an effective tool in treatment for benign primary hyperaldosteronism caused by aldosterone secreting adenomas.