Primary aldosteronism: Establishment of tissue-sparing adrenalectomy according to the results of segmental adrenal venous sampling

• Project/Area Number: 16K11062
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Urology
• Research Institution: Tohoku University
• Principal Investigator: ISHIDOYA SHIGETO 東北大学, 医学系研究科, 非常勤講師 (00344656)
• Co-Investigator(Kenkyū-buntansha): 海法 康裕 東北大学, 医学系研究科, 非常勤講師 (30447130) ; 森本 玲 東北大学, 大学病院, 講師 (30547394) ; 高瀬 圭 東北大学, 医学系研究科, 教授 (60361094) ; 伊藤 明宏 東北大学, 医学系研究科, 教授 (70344661) ; 三塚 浩二 東北大学, 医学系研究科, 准教授 (80568171) ; 川崎 芳英 東北大学, 大学病院, 助教 (80722256)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 原発性アルドステロン症 / 腹腔鏡手術 / 副腎静脈サンプリング / 部分切除術 / 機能温存 / 副腎静脈

Outline of Final Research Achievements

We evaluated whether laparoscopic adrenalectomy (ADX) would improve general health-related quality of life (HRQOL) and nocturia for patients with primary aldosteronism (PA). A total of 173 patients were asked to fill out the HRQOL questionnaires RAND 36-Item Health Survey (SF-36) and International Prostate Symptom Score (I-PSS) preoperatively. Patients were associated with significantly low score of General Health domain compared with normal Japanese population. Among 4 physical domains, General Health scored significantly higher throughout the post-operative period. Among 4 mental domains, scores of Vitality, Social Function, and Mental Health significantly increased after ADX. Patients with PA were suffered from average 2.6 times of urination per night, which significantly decreased after ADX. ADX for PA patients generally improved HRQOL for 2 years. Patients with PA were associated with nocturia which was significantly recovered by ADX.

Academic Significance and Societal Importance of the Research Achievements

原発性アルドステロン症において、副腎静脈サンプリングに基づいた腹腔鏡下副腎全摘術/部分切除術は高血圧や高アルドステロン血症による臓器障害を治療・予防する。さらには、患者自体が実感するところの生活の質をも改善することが本研究で明らかとなった。原発性アルドステロン症の潜在患者は多く、この研究結果は、手術介入によりこの疾患の患者に福音をもたらすエビデンスの一つとして重要と思われる。

Research Products

• [Journal Article] Changes of quality of life after laparoscopic adrenalectomy for patients with primary aldosteronism: Prospective 2 year longitudinal cohort study in a Japanese tertiary center. (2019)
  • Author(s): Ishidoya S, Kawasaki Y, Namiki S, Morimoto R, Takase K, Ito A.
  • Journal Title: International Journal of Urology Volume: -
  • Peer Reviewed
• [Journal Article] Progress in the management of primary aldosteronism (2018)
  • Author(s): Morimoto R, Omata K, Ito S, Satoh F.
  • Journal Title: American Journal of Hypertension Volume: 31 Pages: 522-531
  • Peer Reviewed
• [Journal Article] Image quality and radiation dose of low-tube-voltage CT with reduced contrast media for right adrenal vein imaging (2018)
  • Author(s): Takahashi Y, Ota H, Omura K, Dendo Y, Otani K, Matsuura T, Kitani M, Seiji K, Tezuka Y, Nezu M, Ono Y, Morimoto R, Satoh F, Takasa K.
  • Journal Title: European Journal of Radiology Volume: 98 Pages: 150-157
  • DOI: 10.1016/j.ejrad.2017.11.017
  • Peer Reviewed
• [Journal Article] Anatomical Variations of the Right Adrenal Vein: Concordance Between (2017)
  • Author(s): Kensuke Omura, Hideki Ota, Yuuki Takahashi, Tomonori Matsuura, Kazumasa
  • Journal Title: Hypertension Volume: 69 Issue: 3 Pages: 428-434
  • DOI: 10.1161/hypertensionaha.116.08375
  • Peer Reviewed
• [Journal Article] 副腎腫瘍の周術期管理：原発性アルドステロン症 (2016)
  • Author(s): 石戸谷滋人、青木大志、高橋正博、佐藤友紀.
  • Journal Title: 日本内分泌・甲状腺外科学会雑誌 Volume: ３３ Pages: 23-26
• [Journal Article] Renal Resistive Index Predicts Postoperative Blood Pressure Outcome in Primary Aldosteronism. (2016)
  • Author(s): Iwakura Y, Ito S, Morimoto R, Kudo M, Ono Y, Nezu M, Takase K, Seiji K, Ishidoya S, Arai Y, Funamizu Y, Miki T, Nakamura Y, Sasano H, Satoh F.
  • Journal Title: Hypertension. Volume: 67 Issue: 3 Pages: 654-660
  • DOI: 10.1161/hypertensionaha.115.05924
  • Peer Reviewed / Open Access
• [Journal Article] A case of bilateral aldosterone-producing adenomas differentiated by segmental adrenal venous sampling for bilateral adrenal sparing surgery. (2016)
  • Author(s): R Morimoto, N Satani, Y Iwakura, Y Ono, M Kudo, M Nezu, K Omata, Y Tezuka, K Seiji, H Ota, Y Kawasaki, S Ishidoya, Y Nakamura, Y Arai, K Takase, H Sasano, S Ito, F Satoh
  • Journal Title: Journal of human hypertension Volume: 30 Issue: 6 Pages: 379-385
  • DOI: 10.1038/jhh.2015.100
  • Peer Reviewed / Open Access
• [Presentation] 重症心不全併発原発性アルドステロン症 に対する腹腔鏡下副腎摘除術 (2018)
  • Author(s): 川崎芳英
  • Organizer: 第32回日本泌尿器内視鏡学会総会
  • Invited
• [Presentation] 原発性アルドステロン症に対する腹腔鏡下副腎摘除術が及ぼすQOL への影響 (2017)
  • Author(s): 川崎芳英、海法康裕、伊藤明宏、森本玲、佐藤友紀、泉秀明、川守田直樹、山下慎一、安達尚宣、三塚浩二、石戸谷滋人、荒井陽一
  • Organizer: 第105回日本泌尿器科学会総会
• [Presentation] QOLからみた高齢原発性アルドステロン症患者に対する腹腔鏡下副腎摘除術の有用性の検討 (2017)
  • Author(s): 川崎芳英、石戸谷滋人、伊藤明宏、海法康裕、三塚浩二、山下慎一、川守田直樹、泉秀明、安達尚宣、森本玲、荒井陽一
  • Organizer: 第29回日本内分泌外科学会総会
• [Presentation] Short-term impact on health-related quality of life of laparoscopic adrenalectomy for primary aldosteronism in Japanese patients (2017)
  • Author(s): Yoshihide Kawasaki, Yasuhiro Kaiho, Hideaki Izumi, Naoki Kawamorita, Shinichi Yamashita, Hisanobu Adachi, Koji Mitsuzuka, Akihiro Ito, Shigeto Ishidoya, Yoichi Arai
  • Organizer: 2017 annual AUA Meeting
• [Presentation] 褐色細胞腫および傍神経節腫に対する到達法を考慮した腹腔鏡下手術の検討 (2016)
  • Author(s): 川崎芳英、武田詩奈子、伊藤明宏、海法康裕、三塚浩二、泉秀明、川守田直樹、山下慎一、安達尚宣、石戸谷滋人、荒井陽一
  • Organizer: 第28回日本内分泌外科学会総会
  • Place of Presentation: 横浜：ロイヤルホールヨコハマ
  • Year and Date: 2016-05-26
• [Presentation] Medium-Term Outcomes after Laparoscopic Adrenalectomy for Primary Aldosteronism (2016)
  • Author(s): Yoshihide Kawasaki, Yasuhiro Kaiho, Akihiro Ito, Koji Mitsuzuka, Fumitoshi Satoh, Ryo Morimoto, Yoshikiyo Ono, Shigeto Ishidoya, Tomonori Matsuura, Hideki Ota, Kei Takase, Yoichi Arai
  • Organizer: 2016 annual AUA Meeting
  • Place of Presentation: San Diego, USA
  • Year and Date: 2016-05-06
  • Int'l Joint Research
• [Presentation] Differences between extra-adrenal paragangliomas and pheochromocytomas in malignant potential (2016)
  • Author(s): Shinako Takeda, Yoshihide Kawasaki, Fumitoshi Satoh, Ryo Morimoto, Koji Mitsuzuka, Yasuhiro Kaiho, Akihiro Ito, Shigeto Ishidoya, Kenji Numahata, Yoichi Arai
  • Organizer: 2016 annual AUA Meeting
  • Place of Presentation: San Diego, USA
  • Year and Date: 2016-05-06
  • Int'l Joint Research
• [Presentation] パネルディスカッション「副腎腫瘍診療に求められるパートナーシップ」機能性副腎腫瘍の外科治療に際して内科医に期待される役割；原発性アルドステロン症とクッシング症候群 (2016)
  • Author(s): 森本 玲、川崎 芳英、石戸谷 滋人、清治 和将、中村 保宏、笹野 公伸、高瀬 圭、荒井 陽一、佐藤 文俊、伊藤 貞嘉
  • Organizer: 第104回日本泌尿器科学会総会
  • Place of Presentation: 仙台：仙台国際センター
  • Year and Date: 2016-04-23
• [Remarks] 腹腔鏡下副腎摘除術の手術統計
  • URL: http://www.uro.med.tohoku.ac.jp/patient_info/seiseki04.html