The Experience Of The Diagnosis And Surgical Treatment Of Primary Aldosteronism 84 Cases

Objectives To retrospectively review the experience of the diagnosis and treatment of primary aldosteronism. Methods We retrospectively analyzed 84 cases with PHA in our hospital from January 2009 to December 2013. The patients were divided into two groups, typical-presentation group(59cases) and atypical-presentation group(25cases), who were diagnosed with adrenocortical adenomas according to the clinical manifestations, serum potassium,24-hour urinary potassium, blood gas analysis, supine and upright aldosterone-to-renin ratio (ARR), adrenal vein sample (AVS), Captopril suppression test, CT scans for topographic diagnoses and surgical findings for pathological diagnoses. With retroperitoneal laparoscopic adrenalectomy treatment.The comparison of the two groups in tumor size, preoperative ASA grading, surgical time, intraoperative blood loss, preoperative preparation time, postoperative hospital stay were analyzed. Results All of the 84 cases were diagnosed with PHA. No significant difference in maximum tumor diameters, surgical time, intraoperative blood loss, postoperative hospital stay between the typical-and atypical-presentation groups (P>0.05). While the preoperative preparation time and preoperative ASA grading were significantly different.(P<0.001). Conclusions Typical and atypical PHA diagnosis and treatment of undifferentiated. The surgical risk in typical-presentation group was higher, and longer preoperative preparation time was needed. AVS is suitable for the early PHA diagnosised or positioning solution.