Laparoscopic adrenalectomy for primary hyperaldosteronism: clinical experience with 60 cases.

PURPOSE: To assess the long-term outcome of patients with primary hyperaldosteronism who underwent laparoscopic adrenalectomy and to study hormone dynamics and differences between postoperative and preoperative blood pressure.

PATIENTS AND

METHODS

From December 1992 to February 2005, 60 patients with primary hyperaldosteronism underwent laparoscopic adrenalectomy at our institution. Their clinical and biochemical parameters were reviewed retrospectively. In 45 patients, it was possible to follow the hormone dynamics and blood pressure to compare the preoperative values with those >or=2 months after the operation.

RESULTS

The average operating time was 261.7 minutes (range 95-835 minutes), and the average blood loss was 204.2 mL (range 10-3740 mL). The average time to ambulation was 1.7 days (range 1-7 days). Five patients (8.3%) had intraoperative hemorrhage that necessitated blood transfusion. Serum aldosterone in all 45 patients who were followed up was normalized postoperatively. At >or=2 months postoperatively, only 12 of the 45 patients (26.7%) needed antihypertensive drug(s).

CONCLUSIONS

Laparoscopic adrenalectomy is a safe and effective way to treat primary hyperaldosteronism. Many of the patients in whom hypertension persisted postoperatively were men or elderly.