Short- and long-term results of laparoscopic adrenalectomy for Conn’s syndrome

Mateusz Wierdak; Grzegorz Sokołowski; Michał Natkaniec; Karolina Morawiec-Sławek; Piotr Małczak; Piotr Major; Alicja Hubalewska-Dydejczyk; Andrzej Budzyński; Michał Pędziwiatr

doi:10.5114/wiitm.2018.74833

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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3/2018
vol. 13

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abstract:

Original paper

Short- and long-term results of laparoscopic adrenalectomy for Conn’s syndrome

Mateusz Wierdak

,

Grzegorz Sokołowski

,

Michał Natkaniec

,

Karolina Morawiec-Sławek

,

Piotr Małczak

,

Piotr Major

,

Alicja Hubalewska-Dydejczyk

,

Andrzej Budzyński

,

Michał Pędziwiatr

Videosurgery Miniinv 2018; 13 (3): 292–298

DOI: https://doi.org/10.5114/wiitm.2018.74833

Online publish date: 2018/04/03

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Introduction
The primary treatment of Conn’s syndrome (CS) is laparoscopic adrenalectomy and aims to normalize arterial blood pressure and biochemical parameters.

Aim
To analyse short- and long-term results of laparoscopic adrenalectomy for Conn’s syndrome (CS).

Material and methods
The analysis included 44 consecutive patients, who underwent laparoscopic adrenalectomy between 2004 and 2015 for CS. We analysed short- and long-terms results of operations. All patients were followed up 6 and 24 months after surgery to determine changes in the biochemical parameters, and clinical regression of arterial hypertension. We also evaluated the aldosteronoma resolution score (ARS) in predicting the resolution of hypertension.

Results
No conversions were needed. Complications occurred in 5 (11.4%) patients. Preoperative hypokalaemia and hypernatraemia were present in 83.4% and 15.8% of patients, respectively. After surgery, both hypokalaemia and hypernatraemia resolved in all patients. At the follow-up 6 months after the surgery, only 11.3% of patients had complete remission (CR) of hypertension. In 43.2% of cases we observed partial remission (PR). After 24 months CR was found in 13.6% of patients, 45.5% patients fulfilled criteria for PR, and 29.5% of patients changed the group of remission comparison to the first follow-up visit. Only 50% of patients with an ARS of 4 or 5 points achieved CR 6 months after surgery.

Conclusions
Laparoscopic adrenalectomy is a safe method of treatment for CS. Although it effectively eliminates electrolyte imbalance, it does not allow for the CR of hypertension in the majority of patients, especially in the elderly group. We did not find ARS to be an effective tool in predicting postoperative resolution of hypertension.

keywords:

Short- and long-term results of laparoscopic adrenalectomy for Conn’s syndrome

Mateusz Wierdak , Grzegorz Sokołowski , Michał Natkaniec , Karolina Morawiec-Sławek , Piotr Małczak , Piotr Major , Alicja Hubalewska-Dydejczyk , Andrzej Budzyński , Michał Pędziwiatr

laparoscopic adrenalectomy, adenoma, adrenal tumour, long-term outcomes, Conn’s syndrome, aldosteronoma

Mateusz Wierdak

,

Grzegorz Sokołowski

,

Michał Natkaniec

,

Karolina Morawiec-Sławek

,

Piotr Małczak

,

Piotr Major

,

Alicja Hubalewska-Dydejczyk

,

Andrzej Budzyński

,

Michał Pędziwiatr