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La radiologia medica

, Volume 121, Issue 10, pp 811–819 | Cite as

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

  • Min-Hsin Yang
  • Yeu-Sheng Tyan
  • Yu-Hui Huang
  • Shao-Chuan Wang
  • Sung-Lang Chen
URO-GENITAL RADIOLOGY

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.

Keywords

Aldosteronism Adrenal Radiofrequency Ablation 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standards

This article does not contain animals performed by any of the authors.

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Copyright information

© Italian Society of Medical Radiology 2016

Authors and Affiliations

  • Min-Hsin Yang
    • 1
  • Yeu-Sheng Tyan
    • 2
  • Yu-Hui Huang
    • 3
    • 4
  • Shao-Chuan Wang
    • 1
  • Sung-Lang Chen
    • 1
    • 4
  1. 1.Department of UrologyChung Shan Medical University HospitalTaichungTaiwan
  2. 2.Department of Medical ImagingChung Shan Medical University HospitalTaichungTaiwan
  3. 3.Department of Physical Medicine and RehabilitationChung Shan Medical University HospitalTaichungTaiwan
  4. 4.School of MedicineChung Shan Medical UniversityTaichungTaiwan

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