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Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone-producing adenoma

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Abstract

Purpose

To retrospectively compare the safety and efficacy of radiofrequency ablation (RFA) with laparoscopic adrenalectomy (LA) in treating aldosterone-producing adenoma (APA) of the adrenal gland.

Materials and methods

From September 2009 to September 2013, seven patients, diagnosed with unilateral adrenal APA and underwent computed tomography (CT)-guided percutaneous RFA, were recruited in this retrospective study. Eighteen unilateral adrenal APA with the same tumor size (<25 mm) who underwent LA during the same interval were enrolled as control group. Treatment success was defined as complete tumor ablation on follow-up CT scan and normalization of serum aldosterone-to-renin ratio. We also compared “normalization ability” between RFA group and LA group. Normalization ability was defined as reduction in blood pressure, decrease in number of antihypertensive medicine use, reduction in serum aldosterone, and increase in serum potassium level.

Results

There was no statistically significant demographic difference in both groups. The mean tumor size was 18 (8–25) mm in RFA and 19 (11–25) mm in LA groups, respectively. There was only one intra-procedure hypertensive crisis in the RFA group. No other complications needed further management in both groups. During an interval of 3–6 months of follow-up, the treatment success rate reached 100 % in the RFA group versus 94.4 % in the LA group. Normalization ability was statistically equivalent in the RFA and the LA group. Comparing with LA group, RFA group demonstrated with less post-operative pain (visual analog scale, 2.0 ± 1.16 vs. 4.22 ± 1.44, p < 0.001) and shorter operative time (105 ± 34 vs. 194 ± 58 min, p < 0.001).

Conclusions

CT-guided percutaneous RFA is effective, safe and is a justifiable alternative for patients who are reluctant or unfit for laparoscopic surgery for the treatment of APA.

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Authors and Affiliations

  1. Department of Urology, Chung Shan Medical University Hospital, No. 110, Chien-Kuo North Rd., Section 1, Taichung, 402, Taiwan

    Min-Hsin Yang, Shao-Chuan Wang & Sung-Lang Chen

  2. Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan

    Yeu-Sheng Tyan

  3. Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan

    Yu-Hui Huang

  4. School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Yu-Hui Huang & Sung-Lang Chen

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  1. Min-Hsin Yang
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Correspondence to Sung-Lang Chen.

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Yang, MH., Tyan, YS., Huang, YH. et al. Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone-producing adenoma. Radiol med 121, 811–819 (2016). https://doi.org/10.1007/s11547-016-0662-1

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  • DOI: https://doi.org/10.1007/s11547-016-0662-1

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