title: Hypertension Cure Following Laparoscopic Adrenalectomy for Hyperaldosteronism is not Universal: Trends Over Two Decades.
abstract: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades.
  
  
  
  This retrospective clinical study included 176 patients who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism from 1995 to 2015. The patients were divided into two groups by decade. The patients' baseline characteristics and the hypertension cure rates were compared between the two groups. Additionally, the values were re-examined based on predictive model predicting postoperative hypertension cure.
  
  
  
  The hypertension cure rate decreased significantly from 51.8 to 31.1%. The following variables were significantly different between the two groups: age, sex, body mass index, history of diabetes mellitus, preoperative systolic and diastolic blood pressures, potassium level, and plasma renin activity.
  
  
  
  This study showed that the number of patients with unfavorable conditions for hypertension cure after adrenalectomy has recently increased. The treatment goal for primary aldosteronism is not only to cure the hypertension but also to prevent organ disorders due to inappropriate aldosterone levels. Therefore, we recommend laparoscopic adrenalectomy for unilateral primary aldosteronism, even if hypertension is not always cured postoperatively. However, clinicians need to fully explain the postoperative hypertension outcomes to primary aldosteronism patients.
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Namekawa
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura-Shi, Chiba, 285-8741, Japan. takanobu.utsumi@med.toho-u.ac.jp.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kaga
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nagano
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kono
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura-Shi, Chiba, 285-8741, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kamiya
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Imamoto
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura-Shi, Chiba, 285-8741, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
mesh_terms: D000315:Adrenalectomy; D000367:Age Factors; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery*; D006973:Hypertension / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D012083:Renin; D011188:Potassium