Efficacy And Safety Of Laparoscopic Adrenal Aldosterone-producing Adenoma Resection Under Day Surgery

Objective:To investigate the safety and efficacy of retroperitoneal laparoscopic adrenal aldosterone-producing adenoma resection in the treatment of aldosterone-producing adenoma under day surgery mode.Methods:The clinical data of 101 patients who were diagnosed with PA and underwent retroperitoneal laparoscopic adrenal aldosterone-producing adenoma resection in the day surgery department and urology department of Shanxi Bethune Hospital from November 2019 to November 2020 were analyzed retrospectively,and 50 cases in the urology department as the control group and 51 cases in the day surgery department as the study group.We compared the basic clinical data,operation situation,and postoperative hospitalization index(including the first exhaust time after surgery,indwelling time of urinary catheter and drainage tube,complications,unplanned re-operation and unplanned readmission within 30 days after discharge,length of stay,and cost of hospitalization)and clinical and biochemical recovery condition between the two groups.Results:There was no statistical difference between the two groups at preoperative baseline(including sex,age,BMI,maximum diameter of tumor,preoperative blood pressure,preoperative serum potassium,glomerular filtration rate,and aldosterone/renin ratio)(P>0.05).Retroperitoneal laparoscopic adrenal aldosterone-producing adenoma resection was successfully performed in both groups,and blood pressure and blood potassium were recovered after surgery,and there was no significant difference in clinical recovery rate(78%vs 64%)and biochemical recovery rate(90%vs 94%)between the two groups after 3 months of follow-up(P>0.05).There was no significant differences in operative time and intraoperative blood loss between the two groups(P>0.05);In study group,the first exhaust time(14.8±2.8 vs 21.5±3.1h)after surgery,the indwelling time of drainage tube(23.5±6.8 vs 44.2±13.4h)and the length of stay(29.4±7.5 vs 82.1±12.9h)were shorter than those in control group(P<0.05),and the total cost of hospitalization(2.29±0.42 vs 2.92±0.63w)was less than that in the control group(P<0.05);None of the patients underwent re-operation and were readmitted within 30 days after discharge,and patients in the study group had lower postoperative complications and total complications than patients in the control group,but there was no statistical difference(P>0.05).Conclusion:Compared with the traditional hospitalization mode,retroperitoneal laparoscopic adrenal aldosterone-producing adenoma resection under day surgery mode is safe and feasible in the treatment of aldosterone-producing adenoma,which can shorten the LOS(length of stay)and reduce the cost of hospitalization.