Laparoscopic adrenalectomy is superior to an open approach to treat primary hyperaldosteronism

We reviewed our institutional experience with primary hyperaldosteronism to compare clinical outcomes after laparoscopic versus open adrenalectomy, Al l patients surgically treated for primary hyperaldosteronism from 1988 thro ugh 1999 are included in this study. Patients were assigned to either the L A (laparoscopic) or OA (open) group depending on the initial surgical appro ach selected for treatment. Records were reviewed to determine demographics , operative results, and complications. Twenty-four patients were surgicall y treated for primary hyperaldosteronism. There were no significant differe nces between groups with respect to age, weight, number of preoperative ant ihypertensive medications, or preoperative potassium level. The results of adrenalectomy with respect to number of postoperative antihypertensive medi cations or serum potassium level were also similar. Operative times were no t significantly different (191 +/- 53 minutes for OA and 205 +/- 88 minutes for LA) between groups, but four LA patients were converted to OA, Estimat ed blood loss was 401 +/- 513 cm(3) for OA and 127 +/- 131 cm(3) for LA (P = 0.07). Hospital length of stay was 6.7 +/- 3.7 days for OA and 3.3 +/- 2. 7 days for LA (P = 0.02). Complications were nine for OA and three for LA ( P = 0.001 by Pearson's Chi square). LA is similar to OA in the treatment of primary hyperaldosteronism. The significantly fewer complications and shor ter length of hospital stay associated with LA makes the laparoscopic appro ach the preferred method for treating primary hyperaldosteronism.