title: Laparoendoscopic single-site adrenalectomy in patients with primary hyperaldosteronism: A prospective study with long-term follow up.
abstract: OBJECTIVE
  Laparoendoscopic single-site (LESS) adrenalectomy is a promising minimally invasive technique, however, the current evidence has not confirmed its long-term effectiveness in primary aldosteronism (PA). We conducted a study to analyze the long-term efficacy of LESS adrenalectomy in patients with PA.
  
  
  METHODS
  A total of 49 patients who had been clinically confirmed with PA who had an indication for unilateral adrenalectomy were included in this study. Perioperative data were obtained for all patients. Blood pressure and the levels of serum aldosterone, renin, and potassium were checked periodically. The median follow-up was 16.5 months.
  
  
  RESULTS
  No intra- or early post-operative complication occurred. All LESS adrenalectomies were completed successfully, except one with laparoscopic conversion. Hypokalemia was resolved in all cases and no patient required potassium supplements after surgery. Post-operative cure of hypertension was achieved in 63% of our patients. Overall, 84% of our PA patients had clinical improvement in blood pressure control after surgery.
  
  
  CONCLUSIONS
  Our long-term experience revealed that LESS adrenalectomy is a safe and effective approach, which demonstrated comparable long-term cure and improvement of hypertension to a conventional laparoscopic series in treating PA.
authors.affiliation: Division of Endocrine and Metabolism, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Hu
authors.affiliation: Division of Nephrology, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Che-Hsiung
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Division of Endocrine and Metabolism, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Leay-Kiaw
authors.initials: LK
authors.lastname: Er
authors.affiliation: Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Chia Da
authors.initials: CD
authors.lastname: Lin
authors.affiliation: Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Ying-Buh
authors.initials: YB
authors.lastname: Liu
authors.affiliation: Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chueh
authors.affiliation: Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; Department of Urology, Tzu Chi University, Medical College, Hualien, Taiwan. Electronic address: tsai1970523@yahoo.com.tw.
authors.forename: Yao-Chou
authors.initials: YC
authors.lastname: Tsai
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: adrenalectomy; laparoendoscopic single-site surgery; primary aldosteronism