The Journal of clinical endocrinology and metabolism · 2021
Surgical Outcomes Among Primary Aldosteronism Patients Without Visible Adrenal Lesions.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Sam Davis, Kline Gregory A, So Benny, Pasieka Janice L, Harvey Adrian, Chin Alex, Przybojewski Stefan J, Leung Alexander A
Аннотация
CONTEXT: Many patients with unilateral primary aldosteronism (PA) have normal adrenal imaging, but little is known about their outcome following adrenalectomy.
OBJECTIVE: To evaluate biochemical and clinical outcomes after adrenalectomy in patients with unilateral PA and normal-appearing adrenal imaging.
DESIGN: Retrospective cohort study of patients seen between January 2006 and May 2018.
SETTING: A Canadian tertiary care PA referral center.
PATIENTS: Consecutive individuals with PA, normal cross-sectional adrenal imaging, and lateralizing adrenal vein sampling (AVS) who underwent adrenalectomy during the study period.
PRIMARY OUTCOME: Biochemical response to adrenalectomy graded according to the Primary Aldosteronism Surgical Outcome criteria.
RESULTS: A total of 40 patients were included. Biochemical outcomes were available for 33 people (mean age, 54.7 years; 91% male; median follow-up, 2.7 months), with 28 (85%) showing a complete or partial response and 5 (15%) with no response. Clinical outcomes were available for 36 people (mean age, 54.6 years; 86% male; median follow-up, 9.8 months), with 31 (86%) demonstrating a complete or partial response and 5 (14%) with no response.
CONCLUSIONS: The prognosis after adrenalectomy is highly favorable for patients with unilateral PA and normal-appearing adrenal imaging. Patients with lateralizing disease should be considered for surgery despite apparently normal adrenal imaging.
OBJECTIVE: To evaluate biochemical and clinical outcomes after adrenalectomy in patients with unilateral PA and normal-appearing adrenal imaging.
DESIGN: Retrospective cohort study of patients seen between January 2006 and May 2018.
SETTING: A Canadian tertiary care PA referral center.
PATIENTS: Consecutive individuals with PA, normal cross-sectional adrenal imaging, and lateralizing adrenal vein sampling (AVS) who underwent adrenalectomy during the study period.
PRIMARY OUTCOME: Biochemical response to adrenalectomy graded according to the Primary Aldosteronism Surgical Outcome criteria.
RESULTS: A total of 40 patients were included. Biochemical outcomes were available for 33 people (mean age, 54.7 years; 91% male; median follow-up, 2.7 months), with 28 (85%) showing a complete or partial response and 5 (15%) with no response. Clinical outcomes were available for 36 people (mean age, 54.6 years; 86% male; median follow-up, 9.8 months), with 31 (86%) demonstrating a complete or partial response and 5 (14%) with no response.
CONCLUSIONS: The prognosis after adrenalectomy is highly favorable for patients with unilateral PA and normal-appearing adrenal imaging. Patients with lateralizing disease should be considered for surgery despite apparently normal adrenal imaging.