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单侧原发性醛固酮增多症腹腔镜肾上腺切除术的结果。

Outcomes after laparoscopic adrenalectomy for unilateral primary aldosteronism.

机构信息

Unidad de Tumores Retroperitoneales, Pélvicos y Adrenales, Servicio de Cirugía General, Hospital Británico de Buenos Aires, Buenos Aires, Argentina. E-mail:

Unidad de Tumores Retroperitoneales, Pélvicos y Adrenales, Servicio de Cirugía General, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2022;82(4):558-563.

Abstract

Unilateral primary aldosteronism (PA) is the most common surgically correctable cause of hypertension. Determination of success after laparoscopic adrenalectomy (LA) is limited by the lack of standardized criteria. We sought to evaluate the surgical recurrence and functional outcomes of LA in patients with Conn's syndrome applying the primary aldosteronism surgical outcome (PASO) Criteria. Descriptive observational analysis of patients treated with LA due to confirmed u nilateral Conn's syndrome between May 2007 and August 2020: Twenty patients were included in the cohort; 16 patients had TLA and other four PLA [58% male, median age 47 (IQR: 44-59.5) years and median follow-up of 64 (IQR: 2-156) ] months. Median tumor size was 1.2 (0.8-1.8) cm. No conversions to open surgery were recorded and the overall morbidity of the series was 1/20. No surgical or biochemical recurrence was observed. Five patients were excluded from the analysis of functional results due to lack of follow-up. According to the PASO criteria, complete, partial, and no success were observed in 8/15, 6/15, and 1/15, respectively. The surgical treatment of the disease is supported by the literature, and we were able to reproduce the results of other series. The use of standardized and reproducible criteria to assess its functional results would be essential for a more complete and integrated evaluation of adrenal surgery.

摘要

单侧原发性醛固酮增多症 (PA) 是最常见的可通过手术纠正的高血压病因。腹腔镜肾上腺切除术 (LA) 后成功的确定受到缺乏标准化标准的限制。我们试图应用原发性醛固酮增多症手术结果 (PASO) 标准评估 Conn 综合征患者 LA 后的手术复发和功能结果。对 2007 年 5 月至 2020 年 8 月期间因确诊单侧 Conn 综合征接受 LA 治疗的患者进行描述性观察分析:该队列包括 20 例患者;16 例患者行经腹腔途径 LA,其他 4 例行经腹膜后途径 LA [58%为男性,中位年龄 47(IQR:44-59.5)岁,中位随访时间 64(IQR:2-156)月]。肿瘤大小中位数为 1.2(0.8-1.8)cm。无中转开放手术,该系列的总发病率为 1/20。未观察到手术或生化复发。由于缺乏随访,有 5 例患者被排除在功能结果分析之外。根据 PASO 标准,8/15、6/15 和 1/15 例患者分别观察到完全、部分和无成功。该疾病的手术治疗得到文献支持,并且我们能够重现其他系列的结果。使用标准化和可重复的标准来评估其功能结果对于肾上腺手术的更完整和综合评估将是至关重要的。

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