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

• Project/Area Number: 25462532
• 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(研究院), 非常勤講師 (00344656)
• Co-Investigator(Kenkyū-buntansha): KAWASAKI YOSHIHIDE 東北大学, 医学系研究科, 助教 (80722256) ; TAKASE KEI 東北大学, 医学系研究科, 教授 (60361094) ; KAIHO YASUHIRO 東北大学, 医学系研究科, 講師 (30447130)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2015: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2014: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2013: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
• 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

Outline of Final Research Achievements

We investigated whether tissue-sparing laparoscopic bilateral adrenal surgery was applicable or not for patients with bilateral primary aldosteronism (PA). Endocrinological examination was conducted for patients with hypertension and PA patients were selected. Segmental adrenal venous sampling (sAVS) was performed for PA patients. Then bilateral intara-adrenal venous map has become apparent which enabled us to recognize the aldosterone-hypersecreting regions. Urologists performed laparoscopic bilateral adrenal surgery with partial conservation (LBASpc) for selected 42 patients with bilateral PA disease. All patients were normalized plasma aldosterone concentration (PAC) and 98 % achieved reduction of antihypertensive medication after LBASpc. Moreover, 72% of patients has become free from corticoid replacement therapy (CRT) after surgery. Preoperative PAC was the risk factor for persistent CRT. The study indicated that LBASpc could be applicable for selected patients with bilateral PA.

Research Products

• [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(1) Pages: 23-26
• [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
• [Journal Article] Intra-adrenal Aldosterone Secretion: Segmental Adrenal Venous Sampling for Localization. (2016)
  • Author(s): N Satani, H Ota, K Seiji, R Morimoto, M Kudo, Y Iwakura, Y Ono, M Nezu, K Omata, S Ito, F Satoh, K Takase
  • Journal Title: Radiology Volume: 278(1) Issue: 1 Pages: 265-274
  • DOI: 10.1148/radiol.2015142159
  • Peer Reviewed
• [Journal Article] Dynamic multidetector CT and non-contrast-enhanced MR for right adrenal vein imaging: comparison with catheter venography in adrenal venous sampling. (2016)
  • Author(s): H Ota, K Seiji, M Kawabata, N Satani, K Omata, Y Ono, Y Iwakura, R Morimoto, Ti Matsuura, M Kudo, J Tominaga, F Satoh, S Ito, K Takase
  • Journal Title: European radiology Volume: 26(3) Issue: 3 Pages: 622-630
  • DOI: 10.1007/s00330-015-3872-3
  • Peer Reviewed
• [Journal Article] PROGRESS IN PRIMARY ALDOSTERONISM:Is there a role for segmental adrenal venous sampling and adrenal sparing surgery in patients with primary aldosteronism? (2015)
  • Author(s): Satoh F, Morimoto R, Seiji K, Satani N, Ota H, Iwakura Y, Ono Y, Kud, M, Nezu M, Omata K, Tezuka Y, Kawasaki Y, Ishidoya S, Arai Y, Takase K, Nakamura Y, McNamara K, Sasano H, Ito S.
  • Journal Title: Eur J Endocrinol. Volume: 173(4) Issue: 4 Pages: 465-477
  • DOI: 10.1530/eje-14-1161
  • Peer Reviewed / Open Access
• [Journal Article] Cost-Effectiveness Analysis of the Diagnosis and Treatment of Primary Aldosteronism in Japan. (2015)
  • Author(s): M Sato, R Morimoto, K Seiji, Y Iwakura, Y Ono, M Kudo, F Satoh, S Ito, T Ishibashi, K Takase
  • Journal Title: Hormone and metabolic research Volume: 47(11) Issue: 11 Pages: 826-832
  • DOI: 10.1055/s-0035-1559645
  • Peer Reviewed
• [Journal Article] Measurement of Peripheral Plasma 18-Oxo-cortisol Can Discriminate Uni-lateral Adenoma From Bilateral Diseases in Patients With Primary Aldosteronism (2015)
  • Author(s): F. Satoh, R. Morimoto, Y. Ono, Y. Iwakura, K Omata, M. Kudo, K. Takase, K. Seiji, H. Sasamoto, S. Honma, M. Okuyama, K. Yamashita, CE.Gomez-Sanchez, WE. Rainey, Y. Arai, H. Sasano, Y. Nakamura, S. Ito
  • Journal Title: Hypertension Volume: 65 Issue: 5 Pages: 1096-1102
  • DOI: 10.1161/hypertensionaha.114.04453
  • Peer Reviewed / Open Access
• [Journal Article] Editorial Comment from Dr Ishidoya to Laparoscopic simultaneous bilateral adrenalectomy for testosterone-secreting bilateral adrenal tumors. (2014)
  • Author(s): Ishidoya S
  • Journal Title: Int J Urol. 2013 May 2. Volume: 21(1) Issue: 1 Pages: 119-119
  • DOI: 10.1111/iju.12190
• [Journal Article] 原発性アルドステロン症の診断治療ガイドライン：特に微小腺腫と治療について (2013)
  • Author(s): 石戸谷滋人
  • Journal Title: Jpn J Endourol. Volume: 26 Pages: 24-28
  • NAID: 130004627185
  • Peer Reviewed
• [Journal Article] 内分泌外科領域で泌尿器科医が用いるアプローチとサージカルデバイス (2013)
  • Author(s): 石戸谷滋人
  • Journal Title: 日本内分泌・甲状腺外科学会雑誌 Volume: 30(3) Pages: 207-211
  • NAID: 130004977229
  • Peer Reviewed
• [Journal Article] 転移性副腎腫瘍の病態と手術 (2013)
  • Author(s): 石戸谷滋人
  • Journal Title: 日本内分泌・甲状腺外科学会雑誌 Volume: 30(1) Pages: 45-49
  • NAID: 130004600600
  • Peer Reviewed
• [Presentation] 原発性アルドステロン症患者における夜間頻尿の検討 (2015)
  • Author(s): 川崎芳英、伊藤明宏、海法康裕、森本玲、高瀬圭、石戸谷滋人、荒井陽一
  • Organizer: 第80回日本泌尿器科学会東部総会
  • Place of Presentation: 東京、（ホテル京王プラザ）
  • Year and Date: 2015-10-24
• [Presentation] 原発性アルドステロン症患者の下部尿路症状の評価 (2015)
  • Author(s): 川崎芳英、海法康裕、伊藤明宏、川守田直樹、山下慎一、石戸谷滋人、森本玲、高瀬圭、荒井陽一
  • Organizer: 第22回日本排尿機能学会総会
  • Place of Presentation: 札幌、（京王プラザホテル札幌）
  • Year and Date: 2015-09-09
• [Presentation] シンポジウム：副腎皮質腫瘍の診断と治療 (2015)
  • Author(s): 川崎芳英、海法康裕、伊藤明宏、石戸谷滋人、森本玲、佐藤文俊、高瀬圭、荒井陽一
  • Organizer: 第27回日本内分泌外科学会総会
  • Place of Presentation: 福島、(コラッセ福島）
  • Year and Date: 2015-05-28
  • Invited
• [Presentation] In primary aldosteronism with bilateral adrenal adnomas, laparoscopic bilateral adrenal surgery could be an optional treatment under selective adrenal venous sampling. (2015)
  • Author(s): Y Kawasaki, S Ishidoya, A Ito, Y Kaiho, R Morimoto, K Takase, Y Arai
  • Organizer: 2015 annual AUA Meeting
  • Place of Presentation: 米国、ニューオリンズ
  • Year and Date: 2015-05-14
  • Int'l Joint Research
• [Presentation] ディベート 3 「腹腔鏡下副腎摘除術」 後腹膜アプローチ (2013)
  • Author(s): 石戸谷滋人
  • Organizer: 第27回日本泌尿器内視鏡学会総会
  • Place of Presentation: 名古屋
  • Invited
• [Presentation] パネルディスカッション アルドステロン症を中心とした副腎腫瘍に対する腹腔鏡手術 (2013)
  • Author(s): 海法康裕
  • Organizer: 第101回日本泌尿器科学会総会
  • Place of Presentation: 札幌
  • Invited
• [Presentation] クリニカルアワー５ 「内分泌外科の進歩」副腎腹腔鏡手術の進歩と適応の拡大 (2013)
  • Author(s): 石戸谷滋人
  • Organizer: 第86回日本内分泌学会総会
  • Place of Presentation: 仙台
  • Invited
• [Book] ベッドサイド泌尿器科 改訂第４版 (2013)
  • Author(s): 石戸谷滋人
  • Total Pages: 13
  • Publisher: 南江堂
• [Book] 臨床泌尿器科 泌尿器科診療ベストNAVI (2013)
  • Author(s): 石戸谷滋人
  • Total Pages: 6
  • Publisher: 医学書院