ArticleGland surgery2025
Factors affecting clinical outcomes of minimally invasive adrenalectomy for unilateral primary aldosteronism: a single-center retrospective cohort study.
Article in Gland surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Primary aldosteronism (PA) is a prevalent cause of endocrine hypertension. While unilateral PA (UPA) is potentially curable by adrenalectomy, complete clinical success (CCS) rates vary significantly. Using international Primary Aldosteronism Surgical Outcomes (PASO) criteria, this study aimed to identify preoperative factors influencing clinical outcomes following minimally invasive adrenalectomy (MIA) for UPA to optimize postoperative management. Methods: We retrospectively analyzed the clinical data of 206 patients who underwent MIA for UPA between January 2018 and January 2023 at our hospital. The PASO criteria were used to assess the clinical outcomes. We comparatively analyzed between-group differences and influencing factors in the CCS and incomplete clinical success (ICS) groups (partial and no success). Results: Statistically significant differences existed between the two groups in pathological type, body mass index (BMI), duration of hypertension, preoperative systolic and diastolic blood pressure, and preoperative potassium (P all <0.05), whereas there were no statistically significant differences in gender, age, tumor location, maximum tumor diameter, surgical method, and preoperative aldosterone to renin ratio (ARR). Univariate logistic regression analysis showed that unilateral adrenal hyperplasia (UAH), BMI, duration of hypertension, preoperative systolic and diastolic blood pressure, and preoperative potassium were associated with the clinical outcomes (P all <0.05). Multivariate logistic regression analysis showed that UAH [odds ratio (OR) =3.920, P=0.04], BMI (OR =1.486, P<0.001), duration of hypertension (OR =1.156, P<0.001), and preoperative systolic blood pressure (OR =1.280, P<0.001) were independent risk factors for ICS. The overall clinical success rate was 85.93%. Conclusions: Patients with UAH, high BMI, preoperative systolic blood pressure, and long duration of hypertension should be followed up for a long period.
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