{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:48:58Z","timestamp":1777312138181,"version":"3.51.4"},"reference-count":52,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"Background: Functional adrenal tumors may contribute to poor hypertension control and electrolyte abnormalities, thus increasing the risk of cardiovascular mortality. Currently, laparoscopic adrenalectomy is an effective surgical option that contributes to improved treatment outcomes as compared to open surgery. The purpose of this study was to evaluate the outcomes of laparoscopic adrenalectomy performed by a general surgeon at a low-volume center and to identify clinicopathological risk factors for postoperative persistent hypertension.<\/jats:p>\n Methods: A retrospective study of patients with functional adrenal tumors who underwent laparoscopic adrenalectomy at Srinakharinwirot University, Thailand, between 2014 and 2022. Clinicopathologic and postoperative data were examined.<\/jats:p>\n \n Results: This study included twenty-five patients; the indications for laparoscopic adrenalectomy included primary aldosteronism in 19 (76%), pheochromocytoma in 4 (16%), and Cushing\u2019s syndrome in 2 (8%). The average time of surgery was 103.5 \u00b1 19.7 min, and intraoperative complications occurred in three patients (12%), with one patient requiring conversion to open surgery (4%). The postoperative systolic (125 \u00b1 15 vs. 158 \u00b1 18 mmHg;\n p<\/jats:italic>\n < 0.001) and diastolic (78.5 \u00b1 6.7 vs. 95.3 \u00b1 10 mmHg;\n p<\/jats:italic>\n = 0.013) blood pressure significantly decreased compared to prior surgery, but only 19 patients (76%) achieved a cure for hypertension. Multivariate analysis revealed that the patient\u2019s physical status, as classified by the American Society of Anesthesiologists (odds ratio (OR) = 0.66, 95% confidence interval (CI) 0.43\u20131.32,\n p<\/jats:italic>\n = 0.001), and the need for at least three antihypertensive medicines (OR = 0.7, 95% CI 0.36\u20131.2,\n p<\/jats:italic>\n = 0.002), were independent predictive factors of persistent hypertension after surgery.\n <\/jats:p>\n Conclusion: Laparoscopic adrenalectomy is a safe and effective surgical treatment for functional adrenal tumors, even when performed in a low-volume center. According to the American Society of Anesthesiologists\u2019 physical categorization, the patient\u2019s physical condition and the necessity for at least three antihypertensive medications are predictors of postoperative hypertension.<\/jats:p>\n Trial registration: The study was registered with the Thai Clinical Registry Trials: TCTR20230707007.<\/jats:p>","DOI":"10.5339\/qmj.2024.30","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T01:30:36Z","timestamp":1723426236000},"source":"Crossref","is-referenced-by-count":1,"title":["Laparoscopic adrenalectomy performed by a general surgeon on functioning adrenal tumors: Treatment outcomes and risk prediction of persistent hypertension"],"prefix":"10.5339","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-983X","authenticated-orcid":true,"given":"Thawatchai","family":"Tullavardhana","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, Thailand*Correspondence: Thawatchai Tullavardhana thawatchait@g.swu.ac.th"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"(2):","key":"CIT0001","series-title":"J Clin Endocrinol Metab","first-page":"637\u201344","article-title":"A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology","volume":"85","author":"Mantero\n \nF","year":"2000;"},{"issue":"(4):","key":"CIT0002","series-title":"Eur J Endocrinol","first-page":"513\u201327","article-title":"Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant, time for a rethink?","volume":"161","author":"Cawood\n \nTJ","year":"2009;"},{"issue":"(9486):","key":"CIT0003","series-title":"Lancet","first-page":"665\u201375","article-title":"Phaeochromocytoma","volume":"366","author":"Lenders\n \nJWM","year":"2005;"},{"issue":"(4):","key":"CIT0004","series-title":"Endocr Rev","first-page":"539\u201353","article-title":"Pheochromocytoma: State-of-the-art and future prospects","volume":"24","author":"Bravo\n \nEL","year":"2003;"},{"issue":"(5):","key":"CIT0005","series-title":"Ann Intern Med","first-page":"424\u20139","article-title":"Management of the clinically inapparent adrenal mass (\u201cincidentaloma\u201d)","volume":"138","author":"Grumbach\n \nMM","year":"2003;"},{"issue":"(6):","key":"CIT0006","series-title":"Clin Endocrinol (Oxf)","first-page":"772\u20138","article-title":"High prevalence of autonomous cortisol and aldosterone secretion from adrenal adenomas","volume":"71","author":"Piaditis\n \nGP","year":"2009;"},{"issue":"(6):","key":"CIT0007","series-title":"Endocr Rev","first-page":"1057\u201388","article-title":"The expanding spectrum of primary aldosteronism: Implications for diagnosis, pathogenesis, and treatment","volume":"39","author":"Vaidya\n \nA","year":"2018;"},{"issue":"(2):","key":"CIT0008","series-title":"Urol Ann","first-page":"94\u20137","article-title":"Laparoscopic adrenalectomy: 10 years experience","volume":"4","author":"Km\n \nA-O","year":"2012;"},{"issue":"(5):","key":"CIT0009","series-title":"Arch Med Sci","first-page":"1010\u20139","article-title":"Perioperative complications of adrenalectomy\u201412 years of experience from a single center\/teaching hospital and literature review","volume":"14","author":"Aporowicz\n \nM","year":"2018;"},{"issue":"(3):","key":"CIT0010","series-title":"JSLS","first-page":"e2015.00036","article-title":"Laparoscopic adrenalectomy for large adrenocortical carcinoma","volume":"19","author":"Machado\n \nNO","year":"2015;"},{"key":"CIT0011","article-title":"Primary hyperaldosteronism: The role of the general surgeons in diagnosis and treatment. In: P\u00e3un DL, Cianci P, Restini E, editors. Adrenal glands\u2014The current stage and new perspectives of diseases and treatment","author":"Tullavardhana\n \nT","year":"2024"},{"issue":"(4):","key":"CIT0012","series-title":"Endocrinol Metab (Seoul)","first-page":"774\u201383","article-title":"Minimally invasive adrenal surgery","volume":"35","author":"Kwak\n \nJ","year":"2020;"},{"key":"CIT0013","series-title":"Gland Surg","first-page":"S166\u201372","article-title":"Robotic adrenalectomy: When and how?","volume":"9","author":"Nomine-Criqui\n \nC","year":"2020;"},{"issue":"(1):","key":"CIT0014","series-title":"BMC Surg","first-page":"432","article-title":"Comparison of lateral transperitoneal and retroperitoneal approaches for homolateral laparoscopic adrenalectomy","volume":"21","author":"Liu\n \nZ","year":"2021;"},{"issue":"(12):","key":"CIT0015","series-title":"Surg Endosc","first-page":"5421\u20137","article-title":"Laparoscopic transperitoneal and retroperitoneal adrenalectomy: A 20-year, single-institution experience with an analysis of the learning curve and tumor size [lap transper and retroper adrenalectomy]","volume":"34","author":"Ottlakan\n \nA","year":"2020;"},{"issue":"(9):","key":"CIT0016","series-title":"ANZ J Surg","first-page":"768\u201373","article-title":"Outcomes of laparoscopic adrenalectomy for hyperaldosteronism","volume":"77","author":"Pang\n \nTC","year":"2007;"},{"issue":"(1):","key":"CIT0017","series-title":"BMC Endocr Disord","first-page":"61","article-title":"Hypertension outcomes of adrenalectomy in patients with primary aldosteronism: A systematic review and meta-analysis","volume":"17","author":"Zhou\n \nY","year":"2017;"},{"issue":"(Suppl. 1):","key":"CIT0018","series-title":"Int J Surg","first-page":"S107\u201311","article-title":"Long-term outcomes of laparoscopic adrenalectomy for Cushing disease","volume":"12","author":"Conzo\n \nG","year":"2014;"},{"issue":"(4):","key":"CIT0019","series-title":"Cent Eur J Urol","first-page":"361\u20135","article-title":"The effect of surgical treatment of phaeochromocytoma on concomitant arteri al hypertension and diabetes mellitus in a single-centre retrospective study","volume":"67","author":"Pogorzelski\n \nR","year":"2014;"},{"key":"CIT0020","series-title":"Integr Blood Press Control","first-page":"55\u201362","article-title":"Current concepts in combination therapy for the treatment of hypertension: Combined calcium channel blockers and RAAS inhibitors","volume":"2","author":"Rubio-Guerra\n \nAF","year":"2009;"},{"issue":"(12):","key":"CIT0021","series-title":"Pharmacoepidemiol Drug Saf","first-page":"1572\u201382","article-title":"Effectiveness of two-drug therapy versus monotherapy as initial regimen in hypertension: A propensity score-matched cohort study in the UK Clinical Practice Research Datalink","volume":"28","author":"Marinier\n \nK","year":"2019;"},{"issue":"(5):","key":"CIT0022","series-title":"Semin Nephrol","first-page":"498\u2013505","article-title":"Ambulatory blood pressure and adherence monitoring: Diagnosing pseudoresistant hypertension","volume":"34","author":"Burnier\n \nM","year":"2014;"},{"issue":"(3):","key":"CIT0023","series-title":"J Hypertens","first-page":"635\u201343","article-title":"Predictors and outcomes of resistant hypertension among patients with coronary artery disease and hypertension","volume":"32","author":"Smith\n \nSM","year":"2014;"},{"issue":"(4):","key":"CIT0024","series-title":"JSLS","first-page":"320\u20135","article-title":"Outcome of patients undergoing laparoscopic adrenalectomy for primary hyperaldosteronism","volume":"8","author":"Goh\n \nBKP","year":"2004;"},{"issue":"(6):","key":"CIT0025","series-title":"Arch Surg","first-page":"646\u201350","article-title":"Factors influencing outcome of surgery for primary aldosteronism","volume":"131","author":"Celen\n \nO","year":"1996;"},{"issue":"(1):","key":"CIT0026","series-title":"Lancet Diabetes Endocrinol","first-page":"41\u201350","article-title":"Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: A systematic review and meta-analysis","volume":"6","author":"Monticone\n \nS","year":"2018;"},{"issue":"(2):","key":"CIT0001","series-title":"J Clin Endocrinol Metab","first-page":"637\u201344","article-title":"A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology","volume":"85","author":"Mantero\n \nF","year":"2000;"},{"issue":"(4):","key":"CIT0002","series-title":"Eur J Endocrinol","first-page":"513\u201327","article-title":"Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant, time for a rethink?","volume":"161","author":"Cawood\n \nTJ","year":"2009;"},{"issue":"(9486):","key":"CIT0003","series-title":"Lancet","first-page":"665\u201375","article-title":"Phaeochromocytoma","volume":"366","author":"Lenders\n \nJWM","year":"2005;"},{"issue":"(4):","key":"CIT0004","series-title":"Endocr Rev","first-page":"539\u201353","article-title":"Pheochromocytoma: State-of-the-art and future prospects","volume":"24","author":"Bravo\n \nEL","year":"2003;"},{"issue":"(5):","key":"CIT0005","series-title":"Ann Intern Med","first-page":"424\u20139","article-title":"Management of the clinically inapparent adrenal mass (\u201cincidentaloma\u201d)","volume":"138","author":"Grumbach\n \nMM","year":"2003;"},{"issue":"(6):","key":"CIT0006","series-title":"Clin Endocrinol (Oxf)","first-page":"772\u20138","article-title":"High prevalence of autonomous cortisol and aldosterone secretion from adrenal adenomas","volume":"71","author":"Piaditis\n \nGP","year":"2009;"},{"issue":"(6):","key":"CIT0007","series-title":"Endocr Rev","first-page":"1057\u201388","article-title":"The expanding spectrum of primary aldosteronism: Implications for diagnosis, pathogenesis, and treatment","volume":"39","author":"Vaidya\n \nA","year":"2018;"},{"issue":"(2):","key":"CIT0008","series-title":"Urol Ann","first-page":"94\u20137","article-title":"Laparoscopic adrenalectomy: 10 years experience","volume":"4","author":"Km\n \nA-O","year":"2012;"},{"issue":"(5):","key":"CIT0009","series-title":"Arch Med Sci","first-page":"1010\u20139","article-title":"Perioperative complications of adrenalectomy\u201412 years of experience from a single center\/teaching hospital and literature review","volume":"14","author":"Aporowicz\n \nM","year":"2018;"},{"issue":"(3):","key":"CIT0010","series-title":"JSLS","first-page":"e2015.00036","article-title":"Laparoscopic adrenalectomy for large adrenocortical carcinoma","volume":"19","author":"Machado\n \nNO","year":"2015;"},{"key":"CIT0011","article-title":"Primary hyperaldosteronism: The role of the general surgeons in diagnosis and treatment. In: P\u00e3un DL, Cianci P, Restini E, editors. Adrenal glands\u2014The current stage and new perspectives of diseases and treatment","author":"Tullavardhana\n \nT","year":"2024"},{"issue":"(4):","key":"CIT0012","series-title":"Endocrinol Metab (Seoul)","first-page":"774\u201383","article-title":"Minimally invasive adrenal surgery","volume":"35","author":"Kwak\n \nJ","year":"2020;"},{"key":"CIT0013","series-title":"Gland Surg","first-page":"S166\u201372","article-title":"Robotic adrenalectomy: When and how?","volume":"9","author":"Nomine-Criqui\n \nC","year":"2020;"},{"issue":"(1):","key":"CIT0014","series-title":"BMC Surg","first-page":"432","article-title":"Comparison of lateral transperitoneal and retroperitoneal approaches for homolateral laparoscopic adrenalectomy","volume":"21","author":"Liu\n \nZ","year":"2021;"},{"issue":"(12):","key":"CIT0015","series-title":"Surg Endosc","first-page":"5421\u20137","article-title":"Laparoscopic transperitoneal and retroperitoneal adrenalectomy: A 20-year, single-institution experience with an analysis of the learning curve and tumor size [lap transper and retroper adrenalectomy]","volume":"34","author":"Ottlakan\n \nA","year":"2020;"},{"issue":"(9):","key":"CIT0016","series-title":"ANZ J Surg","first-page":"768\u201373","article-title":"Outcomes of laparoscopic adrenalectomy for hyperaldosteronism","volume":"77","author":"Pang\n \nTC","year":"2007;"},{"issue":"(1):","key":"CIT0017","series-title":"BMC Endocr Disord","first-page":"61","article-title":"Hypertension outcomes of adrenalectomy in patients with primary aldosteronism: A systematic review and meta-analysis","volume":"17","author":"Zhou\n \nY","year":"2017;"},{"issue":"(Suppl. 1):","key":"CIT0018","series-title":"Int J Surg","first-page":"S107\u201311","article-title":"Long-term outcomes of laparoscopic adrenalectomy for Cushing disease","volume":"12","author":"Conzo\n \nG","year":"2014;"},{"issue":"(4):","key":"CIT0019","series-title":"Cent Eur J Urol","first-page":"361\u20135","article-title":"The effect of surgical treatment of phaeochromocytoma on concomitant arteri al hypertension and diabetes mellitus in a single-centre retrospective study","volume":"67","author":"Pogorzelski\n \nR","year":"2014;"},{"key":"CIT0020","series-title":"Integr Blood Press Control","first-page":"55\u201362","article-title":"Current concepts in combination therapy for the treatment of hypertension: Combined calcium channel blockers and RAAS inhibitors","volume":"2","author":"Rubio-Guerra\n \nAF","year":"2009;"},{"issue":"(12):","key":"CIT0021","series-title":"Pharmacoepidemiol Drug Saf","first-page":"1572\u201382","article-title":"Effectiveness of two-drug therapy versus monotherapy as initial regimen in hypertension: A propensity score-matched cohort study in the UK Clinical Practice Research Datalink","volume":"28","author":"Marinier\n \nK","year":"2019;"},{"issue":"(5):","key":"CIT0022","series-title":"Semin Nephrol","first-page":"498\u2013505","article-title":"Ambulatory blood pressure and adherence monitoring: Diagnosing pseudoresistant hypertension","volume":"34","author":"Burnier\n \nM","year":"2014;"},{"issue":"(3):","key":"CIT0023","series-title":"J Hypertens","first-page":"635\u201343","article-title":"Predictors and outcomes of resistant hypertension among patients with coronary artery disease and hypertension","volume":"32","author":"Smith\n \nSM","year":"2014;"},{"issue":"(4):","key":"CIT0024","series-title":"JSLS","first-page":"320\u20135","article-title":"Outcome of patients undergoing laparoscopic adrenalectomy for primary hyperaldosteronism","volume":"8","author":"Goh\n \nBKP","year":"2004;"},{"issue":"(6):","key":"CIT0025","series-title":"Arch Surg","first-page":"646\u201350","article-title":"Factors influencing outcome of surgery for primary aldosteronism","volume":"131","author":"Celen\n \nO","year":"1996;"},{"issue":"(1):","key":"CIT0026","series-title":"Lancet Diabetes Endocrinol","first-page":"41\u201350","article-title":"Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: A systematic review and meta-analysis","volume":"6","author":"Monticone\n \nS","year":"2018;"}],"container-title":["Qatar Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2024\/3\/article-30.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2024\/3\/article-30.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2024\/3\/article-30.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:12:56Z","timestamp":1777309976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2024\/3\/article-30.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":52,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5339\/qmj.2024.30","relation":{},"ISSN":["2227-0426"],"issn-type":[{"value":"2227-0426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]}}}