Using PASO Criteria To Evaluate The Efficacy Of Two Surgical Methods In The Treatment Of Unilateralaldosterone-producing Adenoma

Objective: To compare the efficacy of total adrenalectomy and partial adrenalectomy in the treatment of unilateral aldosterone-producing adenoma by using The Primary Aldosteronism Surgical Outcome(PASO)criteria,so as to provide basis for the selection of surgical methods for unilateral aldosterone-producing adenoma.Methods: From January 2013 to March 2020,245 patients with unilateral aldosteronoma underwent surgery,124 cases(50.6%)underwent retroperitoneal laparoscopic total adrenalectomy(total adrenalectomy group)and 121 cases(49.4%)retroperitoneal laparoscopic partial adrenalectomy(partial adrenalectomy group).The average follow-up was24 months.The basic characteristics,surgical data,perioperative complications,postoperative hormone supplementation and postoperative follow-up results were compared between the two groups.Results: There was no significant difference in operation time,intraoperative bleeding,24-hour Δ Hb,perioperative blood transfusion rate,postoperative clinical index,postoperative hospital stay and postoperative hormone supplementation between the two groups.In the total resection group,there were 15 cases of multiple tumors(12.1%);AVS,89.4%,76.4%).According to the PASO criteria,there was no significant difference in the overall clinical remission rate(complete remission + partial remission)of 97.6% vs 94.2% and the overall biochemical remission rate of 99.2% vs 95.8% between the two groups.The recurrence rate in the total resection group was 0,which was 2.5% lower than that in the partial resection group,but there was no significant difference between the two groups(P > 0.05).Conclusion: Total adrenalectomy is safe and effective in the treatment of aldosterone-producing adenoma,and partial adrenalectomy has a small number of recurrent cases,so total adrenalectomy may be a more effective surgical method for unilateral aldosterone-producing adenoma.