Abdel-Aziz Tarek, Abdelsalam Alaa, Chung Teng-Teng, Srirangalingam Umasuthan, Hurel Steven, Conway Gerard, Baldeweg Stephanie E, Kurzawinski Tom R
Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK.
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Hormones (Athens). 2025 Mar;24(1):251-258. doi: 10.1007/s42000-024-00613-3. Epub 2024 Nov 18.
Primary aldosteronism (PA), which is the commonest cause of secondary hypertension, can be cured by unilateral adrenalectomy. We report the short-and long-term outcomes after adrenalectomy performed at a single UK center over a period of 24 years.
Retrospective analysis of biochemical (potassium, aldosterone, renin, and ARR) radiological (CT/MRI, AVS, and nuclear scans), and clinical (surgical complications, blood pressure, and number of antihypertensive medications) short-and long-terms outcomes in patients who underwent adrenalectomy for PA between 1998 and 2021. Standardized PASO and Clavien-Dindo criteria to assess biochemical, clinical, and surgical outcomes were used.
A total of 82 patients were treated via adrenalectomy for PA over a 24-year period. Short-term follow-up data (within 3 months after surgery) was available for all 82 patients (M45, F37, mean age 51.7 years): 24 of them were followed up for at least 60 months (range 60 to 72 months) and 77 (93.9%) patients had laparoscopic surgery (one conversion). Seven patients had postoperative complications classified as Clavien-Dindo II (4), IIIa(1) and IVa(2). Median LOS was 2.5 days (1-12). Complete and partial clinical success was achieved in 29 and 58.3% and 41.7 and 45.8% of patients in the short and the long term, respectively. Clinical benefit was observed in 88% of patients. Complete biochemical success was achieved in 95.8% of patients in the short and the long term.
Unilateral adrenalectomy in patients with PA showed clinical benefit in 88% and achieved biochemical cure in almost all of them. Our data suggest that these benefits persisted for at least 5 years.
原发性醛固酮增多症（PA）是继发性高血压最常见的病因，可通过单侧肾上腺切除术治愈。我们报告了英国一家中心在24年期间进行肾上腺切除术后的短期和长期结果。
回顾性分析1998年至2021年间因PA接受肾上腺切除术患者的生化指标（钾、醛固酮、肾素和ARR）、影像学检查（CT/MRI、AVS和核扫描）以及临床指标（手术并发症、血压和抗高血压药物数量）的短期和长期结果。采用标准化的PASO和Clavien-Dindo标准评估生化、临床和手术结果。
在24年期间，共有82例患者因PA接受了肾上腺切除术。所有82例患者（男性45例，女性37例，平均年龄51.7岁）均有短期随访数据（术后3个月内）：其中24例患者随访至少60个月（范围60至72个月），77例（93.9%）患者接受了腹腔镜手术（1例中转）。7例患者术后出现并发症，根据Clavien-Dindo分类为II级（4例）、IIIa级（1例）和IVa级（2例）。中位住院时间为2.5天（1至12天）。短期和长期分别有29%和58.3%以及41.7%和45.8%的患者实现了完全和部分临床成功。88%的患者观察到临床获益。短期和长期分别有95.8%的患者实现了完全生化治愈。
PA患者的单侧肾上腺切除术使88%的患者获得临床获益，几乎所有患者都实现了生化治愈。我们的数据表明，这些益处至少持续5年。
