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

2015 Fiscal Year Final Research Report

• 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
• 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.

Free Research Field

医歯薬学