1991 Volume 41 Issue 1 Pages 209-218
Forty cases of primary aldosteronism were encountered at the Second Department of Surgery in Gunma University. In the present study, we evaluated the methods to localize the sites of tumors, operative procedures and the effects of removal of tumors on clinical manifestations. The localization of tumors were mainly established by adrenal computed tomographic scan (CT), venography, venous sampling and iodo-cholesterol scan. The accuracy rates of these methods were as followings, CT (89%), venography (70%), venous sampling (63%), and iodocholesterol scan (63%), respectively. In these combined methods, we could obtain 100% accuracy in the decision of localization. Adrenal explorations through a posterolateral approach were performed in 35 patients. To compare with transperitoneal approach, the amount of blood loss were smaller and the duration of operation were shorter. From these result, posterolateral approach may be most available procedure in adrenal exploration for aldosterone-producing adenoma. The levels of plasma renin activity, aldosterone and electrolytes were normalized in all patients after removal of tumors, while normal blood pressure was not obtained in some patients. Thus, the results of operative management for primary aldosteronism was mostly satisfactory and long-term follow-up and control of blood pressure might be necessary.
