The Efficacy And Safety Of Retroperitoneal Laparoscopic Adrenal-sparing Surgery For Primary Aldosterone-producing Adenoma

Objective: To observe the clinical application of retroperitoneal laparoscopic adrenal-sparing surgery in the treatment of aldosterone-producing adenoma.Methods: The clinical data of 56 patients with aldosterone-producing adenoma from May 2014 to February 2018 in the Department of Urology,Second Affiliated Hospital of Chongqing Medical University were analyzed retrospectively,of which 34 patients underwent adrenal-sparing surgery,and 22 patients underwent total adrenalectomy.Results: All the 56 patients completed the operation successfully.The two groups showed no statistically significant difference in the following aspects(P>0.05): operation time,(75.5±10.4)min vs(70.0±9.6)min;the intraoperative blood loss,(43.0±7.4)mL vs(40.2±5.5)mL;the drainage tube time,(2.3±0.9)d vs(2.7±1.1)d,postoperative length of hospital stay,(5.8±2.1)d vs(6.4±3.3)d;lesion size,(16.4±7.7)mm vs(18.8±4.9)mm.All the patients were followed up for 8 months to 12 months postoperatively,and all patients did not relapse during the follow-up period.There is no significant differences in reducing blood potassium,reducing blood aldosterone,and improving blood pressure between two groups(P>0.05).Compared with the adrenalectomy group,the adrenal-sparing group had a smaller average dose of hormone replacement and a shorter time period for quitting hormone replacement:(12.03±1.65)mg/d vs(13.12±1.45)mg/d,(P<0.05);(4.06±1.43)weeks vs(7.86±1.72)weeks(P<0.05).Conclusion: Selective and proper adrenal-sparing surgery for patients with aldosterone-producing adenoma is similar to unilateral adrenalectomy in terms of efficacy and safety.It has obvious advantages in the postoperative hormone replacement process,and is worthy of clinical promotion.