Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 25 P181

SFEBES2011 Poster Presentations Endocrine tumours and neoplasia (36 abstracts)

Laparoscopic adrenalectomy for Conn’s syndrome benefits is beneficial to patients and to health finances

Heather White , Samantha Jayaweera , Gregory Sadler & Radu Mihai


John Radcliffe Hospital, Oxford, UK.


Background: Primary hyperaldosteronism is allegedly present in 10% of hypertensive patients. Conn’s syndrome is present in a third of such patients and adrenalectomy has the potential to cure/improve the control of hypertension. This study assesses the benefits/costs of laparoscopic adrenalectomy (LA) in a cohort of consecutive patients with Conn’s syndrome operated in a tertiary referral centre.

Methods: Clinical, radiological, operative and pathological data were collected on patients undergoing adrenalectomy for Conn’s syndrome over a 6 years period.

Results: Between Jan 05 and Oct 10 a total of 24 patients (9M:15F, age 34–75 years, median 51 years) underwent LA for Conn’s syndrome. Localisation of the adenoma was based on results of CT scans (n=19), MRI scans (n=6) and selective adrenal venous sampling (n=17). Uneventful LA was performed in 21 patients and three patients needed conversion to open operation. Mean operative time was 80 min (range 20–125 min) and mean postoperative stay was 2±1.4 days (range 1–7 days, mode 1 day). Hospital costs were calculated to be £9180 for radiological investigations, £7920 for outpatient assessment, £14 100 for in-hospital stay, £30 000 for operating theatre use and £12 000 for disposable surgical instruments. These costs averaged to £3050/patient, that is within the national tariff for adrenalectomy (HRGKA04z=£3333).

Follow-up by postal questionnaire in September 2010 had a response rate of 61% (14 of 23 patients) at a mean post-operative time of 37±4 months. 93% (13 of 14) patients reported taking no/fewer anti-hypertensive medications, with each patient being prescribed two fewer medications on average. 86% (12 of 14) patients reported improved quality of life post-operatively (10-point scale) and all patients stated that they would definitely have the operation again in preference to anti-hypertensive medications.

Conclusion: Laparoscopic adrenalectomy for Conn’s syndrome has a positive impact on blood pressure control and quality of life of patients. This diagnostic and therapeutic protocol is cost-effective.

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