Laparoscopic simultaneous bilateral adrenalectomy for patients with bilateral aldosterone-producing (micro)adenoma: Assessment of feasibility and potential indication

2012 Fiscal Year Final Research Report

• Project/Area Number: 22591804
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Urology
• Research Institution: Tohoku University
• Principal Investigator: ISHIDOYA Shigeto 東北大学, 大学院・医学系研究科, 非常勤講師 (00344656)
• Co-Investigator(Kenkyū-buntansha): ARAI Yoichi 東北大学, 大学院・医学系研究科, 教授 (50193058)
• Project Period (FY): 2010 – 2012
• 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 / 両側手術

Research Abstract

We evaluated the feasibility and outcomes of laparoscopic adrenalectomy (LA) for patients with unilateral/bilateral aldosterone-producing adenomas. All patients with primary aldosteronism (PA) were conducted adrenal venous sampling and were decided hyper-secreting side(s). (1)A total of 174 cases with unilateral PA received unilateral total LA. All procedures were safely performed. Nearly one fourth of them were aldosterone-producing microadenoma. Plasma aldosterone concentration and anti-hypertensive drugs were significantly decreased after surgery (p<0.01, p<0.05). Hypertension was cured/improved in 89.1% of patients. (2) A total of 45 patients with bilateral adrenal disease (including 29 cases of bilateral PA) were performed simultaneous bilateral LA. All procedures were also safely accomplished without adrenal insufficiency. Patients undergoing adrenal-sparing bilateral LA required glucocorticoid replacement; however, all discontinued within 24 months. Either unilateral or bilateral LA was safely performed. These procedures for patients with unilateral/bilateral PA couldbring about satisfied surgical and endocrinological outcomes.

Research Products

• [Journal Article] Editorial Comment from Dr Ishidoya to Polymorphic variation of CYP11B2 predicts postoperative resolution of hypertension in patients undergoing adrenalectomy for aldosterone-producing adenomas (2012)
  • Author(s): Ishidoya S.
  • Journal Title: Int J Urol Volume: 19(9) Pages: 820-1
  • DOI: doi:10.1111/j.1442-2042.2012.03059.x.
• [Journal Article] Difficult-to-controlhypertension due to bilateral aldosterone-producing adreno -cortical microadenomas associated with a cortisol-producing adrenal macroadenoma (2011)
  • Author(s): Morimoto R, Kudo M, Murakami O, Takase K, Ishidoya S, Nakamura Y, Ishibashi T, Takahashi S, Arai Y, Suzuki T, Sasano H, Ito S, Satoh F.
  • Journal Title: J Hum Hypertens Volume: 25(2) Pages: 114-121
  • DOI: doi:10.1038/jhh.2010.35.
  • Peer Reviewed
• [Journal Article] Single-center outcome of laparoscopic unilateral adrenalectomy for patients with primary aldosteronism: Lateralizing disease using results of adrenal venous sampling (2011)
  • Author(s): Ishidoya S, Kaiho Y, Ito A, Morimoto R, Satoh F, Ito S, Ishibashi T, Nakamura Y, Sasano H, Arai Y.
  • Journal Title: Urology Volume: 78 Pages: 68-73
  • DOI: doi:10.1016/j.urology.2010.12.042.
  • Peer Reviewed
• [Journal Article] Surgicaloutcomes of laparoscopic adrenalectomy for patients with Cushing's and subclinical Cushing's syndrome: a single center experience (2011)
  • Author(s): Miyazato M, Ishidoya S, Satoh F, Morimoto R, Kaiho Y, Yamada S, Ito A, Nakagawa H, Ito S, Arai Y.
  • Journal Title: Int Urol Nephrol Volume: 43 Pages: 975-981
  • DOI: doi:10.1007/s11255-011-9950-9.
  • Peer Reviewed
• [Journal Article] Lumbar incisional hernia of the kidney after laparoscopic adrenalectomy in a patient with Cushing's syndrome (2011)
  • Author(s): Miyazato M, Yamada S, Kaiho Y, Ito A, Ishidoya S, Arai Y.
  • Journal Title: Int Urol Nephrol Volume: 43(4) Pages: 975-81
  • DOI: doi:10.1159/000329284.
  • Peer Reviewed
• [Journal Article] Editorial Comment to Increased expression of CYP17 and CYP11B1 in subclinical Cushing's syndrome due toadrenal adenomas (2011)
  • Author(s): Ishidoya S.
  • Journal Title: Int J Urol Volume: 18(10) Pages: 697
  • DOI: doi:10.1111/j.1442-2042.2011.02840.x.
• [Journal Article] Laparoscopic simultaneous bilateral adrenalectomy: assessment of feasibility and indication (2011)
  • Author(s): Kawasaki Y, Ishidoya S, Kaiho Y, Ito A, Satoh F, Morimoto ,Nakagawa H, Arai Y.
  • Journal Title: Int J Urol Volume: 18 Pages: 762-767
  • DOI: doi:10.1111/j.1442-2042.2011.02846. x.
  • Peer Reviewed
• [Presentation] Preliminary experience oflaparoscopic simultaneous bilateral adrenalectomy for patients with aldosterone-producing adenoma (2012)
  • Author(s): Shigeto Ishidoya, Akihiro Ito, Yoshihide Kawasaki, Minoru Miyazato, Yasuhiro kaiho, Haruo Nakagawa, Fumitoshi Satoh, Ryo Morimoto, Kei Takase, Yoichi Arai
  • Organizer: 27th Annual EAU Congress
  • Place of Presentation: Paris
  • Year and Date: 20120524-28
• [Presentation] 卒後教育プログラム副腎および後腹膜腫瘍の診断と治療副腎腫瘍の診断・機能評価・外科的治療-PAを中心に (2012)
  • Author(s): 石戸谷滋人
  • Organizer: 第100回日本泌尿器科学会総会
  • Place of Presentation: 東京
  • Year and Date: 20120421-24
• [Presentation] Single center outcome of laparoscopic adrenalectomy for patients with unilateral aldosterone excess (2011)
  • Author(s): Shigeto Ishidoya, Akihiro Ito, Yoshihide Kawasaki, Minoru Miyazato, Yasuhiro kaiho, Haruo Nakagawa, Yoichi Arai.
  • Organizer: lateralizing disease based on the results of adrenal venous sampling2011 AUA annual Meeting
  • Place of Presentation: Washington DC
  • Year and Date: 20110514-19
• [Presentation] 卒後教育プログラム内分泌・生殖機能・性機能・副腎腫瘍の実際原発性アルドステロン症:泌尿器科医が知っておくべき最近の知見 (2011)
  • Author(s): 石戸谷滋人
  • Organizer: 第99回日本泌尿器科学会総会
  • Place of Presentation: 名古屋
  • Year and Date: 20110420-24
• [Presentation] 両側性副腎疾患に対する-期的腹腔鏡下両側手術の経験 (2010)
  • Author(s): 石戸谷滋人、川崎芳英、山田成幸、三塚浩二、宮里実、齋藤英郎、海法康裕、伊藤明宏、中川晴夫、荒井陽一
  • Organizer: 第24回日本Endourology・ESWL学会総会
  • Place of Presentation: 京都
  • Year and Date: 20101021-23
• [Presentation] Experience of laparoscopic adrenalectomyfor patients with aldosterone-producing microadenoma (2010)
  • Author(s): Shigeto Ishidoya, Akihiro Ito, Yoshihide Kawasaki, Yasuhiro Kaiho, Haruo Nakagawa, Yoich Arai
  • Organizer: 28th World Congress of Endourology
  • Place of Presentation: Chicago
  • Year and Date: 20100901-04
• [Presentation] Single center outcome of laparoscopic adrenalectomy for 237 consecutive patients with aldosterone-producing adenoma (2010)
  • Author(s): Shigeto Ishidoya, Akihiro Ito, Haruo Nakagawa, Yoshihide Kawasaki, Fumitoshi Satoh, Tadashi Ishibashi, Yoichi Arai.
  • Organizer: Experience based on the Endocrine Society Clinical Practice Guideline2010 AUA annual Meeting
  • Place of Presentation: San Francisco
  • Year and Date: 20100529-0603
• [Presentation] 「原発性アルドステロン症ガイドライン」に準拠した局在診断に基づく、アルドステロン産生腺腫の大規模治療アウトカム (2010)
  • Author(s): 石戸谷滋人、川崎芳英、伊藤明宏、海法康裕、森本玲、佐藤文俊、石橋忠司、笹野公伸、荒井陽一
  • Organizer: 第98回日本泌尿器科学会総会
  • Place of Presentation: 盛岡
  • Year and Date: 20100427-30
• [Book] ベッドサイド泌尿器科(第四版),『原発性アルドステロン症』『副腎皮質癌』 (2013)
  • Author(s): 石戸谷滋人
  • Publisher: 南江堂
• [Book] 泌尿器科診療ガイド(第一版),『原発性アルドステロン症』 (2011)
  • Author(s): 石戸谷滋人
  • Total Pages: 62-64
  • Publisher: 金芳堂
• [Remarks] 1.2010.2.21読売新聞からだの質問箱検診で「副腎腫瘍の疑い」回答者:石戸谷滋人 新聞報道
• [Remarks] 1.石戸谷滋人「原発性アルドステロン症:診断と治療の新展開」第16回奈良県医師会泌尿器科部会Current Topics in Urology研究会平成22年6月5日(奈良) 講演
• [Remarks] 2.石戸谷滋人「原発性アルドステロン症:診断と治療の新展開」第22回青森内分泌研究会平成22年7月24日(弘前:弘前大学) 講演
• [Remarks] 3.石戸谷滋人「原発性アルドステロン症～診断と治療の新たな試み～」第12回岐阜泌尿器科手術手技研究会平成22年10月23日(岐阜会館) 講演
• [Remarks] 4.石戸谷滋人「原発性アルドステロン症における新たな診断と治療」第75回宮城内分泌研究会平成24年5月30日(仙台:艮陵会館) 講演