楊旻鑫1, 田雨生2, 陳順郎1
1中山醫學大學附設醫院 泌尿科; 2中山醫學大學附設醫院 放射科
Comparison of radiofrequency ablation versus laparoscopic adrenalectomy for benign aldosterone-producing adenoma
Ming-Hsin Yang1, Y.S. Tyan2, and Sung-Lang Chen1
1Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
2Department of Medical imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
Purpose: Evaluate the safety and efficacy of radiofrequency ablation (RFA) in treating aldosteronism producing adenoma (APA) of adrenal gland.
Materials and Methods: We retrospective evaluated a patient cohort with computed tomography (CT) - guided percutaneous RFA performed on APA of size 2.5 cm or less. Treatment success was defined as complete tumor ablation on follow-up CT scan plus normalization of serum aldosterone-to-renin ratio. We also made comparison of “normalization ability” with previous conventional LA for APA. The normalization ability was defined as reduction amount of blood pressure, number of hypertensive medicine use, aldosterone level, and increased in potassium level.
Results: Between September 2009 till September 2013, 25 patients were included with the diagnosis of unilateral APA, 7 underwent RFA and 18 underwent LA. The tumor sizes ranged from 8-25 mm. There was one intra-procedure HTN crisis during RFA. Both groups presented no complications which need further management. During a 3 to 6 months followed up, total response rate reached 100% in RFA group versus 94.4% in LA group. Normalization ability was statistical equivalent between RFA and LA group.
Conclusion: CT- guided percutaneous RFA is efficatious and safe in treating APA. It is a justifiable alternative for patients who are reluctant or unfit for surgery.