{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:16:59Z","timestamp":1790864219954,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,3,15]],"date-time":"2008-03-15T00:00:00Z","timestamp":1205539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with primary hyperaldosteronism, solitary adrenal adenomas are an indication for surgical intervention. In contrast, adrenal hyperplasia is almost exclusively treated by drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>In a prospective clinical study 183 patients (81\u00a0men, 102 women; age 49.6 \u00b1 12.8 years) with Conn\u2019s syndrome were operated on using the posterior retroperitoneoscopic approach. Tumor size ranged from 0.2 to 5.0\u00a0cm (mean 1.5 \u00b1 0.8\u00a0cm). Final histology described a solitary adenoma in 127 patients and adrenal hyperplasia in 56 patients. Partial adrenalectomies were performed in 47 operations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The perioperative complication rate was 4%, mortality zero. In none of the cases was conversion to open surgery necessary. The mean operating time was 58 \u00b1 32\u00a0minutes (range 20\u2013230\u00a0minutes) and was associated with sex (<jats:italic>p<\/jats:italic> &lt; 0.001) but not with the extent of resection (partial vs. total, <jats:italic>p<\/jats:italic> = 0.51) or with tumor size (\u22641.5 vs. &gt;1.5\u00a0cm; <jats:italic>p<\/jats:italic> = 0.43) or tumor site (<jats:italic>p<\/jats:italic> = 0.77). Median blood loss was 15\u00a0ml. Median duration of postoperative hospitalization was 4\u00a0days. After a mean follow\u2010up of nearly 5 years, 96% of patients are normokalemic, 30% of patients are cured (normotensive without medication), and 87% showed an improvement of hypertension (normotensive without or with reduced medication). Cure of hypertension depended on the patient\u2019s age (<jats:italic>p<\/jats:italic> &lt; 0.001) and sex (<jats:italic>p<\/jats:italic> &lt; 0.001), duration of hypertension (<jats:italic>p<\/jats:italic> &lt; 0.05), and histomorphology (<jats:italic>p<\/jats:italic> &lt; 0.001). Improvement of hypertension was not associated with any of these factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Retroperitoneoscopic removal of adrenal glands in patients with Conn\u2019s syndrome is a safe, rapidly performed surgical procedure and can thus be considered as first choice option for treatment of both solitary adrenal adenomas and hyperplasia presenting with a clinically predominating nodule.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-008-9513-0","type":"journal-article","created":{"date-parts":[[2008,3,14]],"date-time":"2008-03-14T12:23:17Z","timestamp":1205497397000},"page":"847-853","source":"Crossref","is-referenced-by-count":82,"title":["Retroperitoneoscopic Adrenalectomy in Conn\u2019s Syndrome Caused by Adrenal Adenomas or Nodular Hyperplasia"],"prefix":"10.1002","volume":"32","author":[{"given":"Martin K.","family":"Walz","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Chirurgie und Zentrum f\u00fcr Minimal 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F.","family":"Alesina","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Chirurgie und Zentrum f\u00fcr Minimal Invasive Chirurgie, Kliniken Essen\u2010Mitte Akademisches Lehrkrankenhaus der Universit\u00e4t Duisburg\u2010Essen, Universit\u00e4t Duisburg\u2010Essen Henricistrasse 92 45136 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Carinna","family":"Suttorp","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie und Neuropathologie Universit\u00e4tsklinikum Essen, Universit\u00e4t Duisburg\u2010Essen Hufelandstrasse 55 45122 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus A.","family":"Metz","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie und Neuropathologie Universit\u00e4tsklinikum Essen, Universit\u00e4t Duisburg\u2010Essen Hufelandstrasse 55 45122 Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank 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