{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:59:51Z","timestamp":1762505991479,"version":"3.41.0"},"reference-count":30,"publisher":"International College of Surgeons","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>The underlying cause of resistant hypertension after adrenalectomy for primary hyperaldosteronism remains controversial. The objective of this study was to identify preoperative factors predictive of resistant hypertension in patients after undergoing retroperitoneoscopic adrenalectomy. Between 2003 and 2009, 124 patients with unilateral aldosterone-producing adenoma or unilateral adrenal hyperplasia underwent retroperitoneoscopic adrenalectomy at our institution. Clinical and biochemical data were reviewed retrospectively at baseline and after a median follow-up time of 59.2 \u00b1 37.2\u00a0months. Adrenalectomy cured hypertension in 68 patients (54.8%) and 43 (34.8%) had persistent hypertension that was much easier to control after surgery, whereas 13 patients (10.4%) had continued hypertension and poor blood pressure control. Multivariate regression analysis revealed that the main determinants of postoperative cure were duration of hypertension less than 5\u00a0years [odds ratio (OR): 6.515, 95% confidence interval (CI) 2.278\u201310.293), number of antihypertensive medications \u22642 (OR: 2.939, 95% CI 1.254\u20135.235), preoperative response to spironolactone (OR: 3.405, 95% CI 1.681\u20136.985), the TT genotype of the CYP11B2 gene (344\u00a0C\/T) (OR: 2.765, 95% CI 1.221\u20134.986), and the presence of adenoma rather than hyperplasia (OR: 5.274, 95% CI 2.150\u20138.141). The main determinants of surgical cure or control of hypertension in patients with primary hyperaldosteronism were duration of hypertension, number of antihypertensive medications, preoperative response to spironolactone, the presence of adenoma, and CYP11B2 (344\u00a0C\/T) genotype. Consideration of these factors may help in the evaluation of patients for surgery and for the identification of patients with continued postoperative hypertension that may require more long-term monitoring and treatment.<\/jats:p>","DOI":"10.9738\/cc140.1","type":"journal-article","created":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T15:57:41Z","timestamp":1351180661000},"page":"104-111","source":"Crossref","is-referenced-by-count":36,"title":["Predictors of Successful Outcome After Adrenalectomy for Primary Aldosteronism"],"prefix":"10.9738","volume":"97","author":[{"given":"Wei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, Guangzhou General Hospital of Guangzhou Military Command (Guangzhou Liuhuaqiao Hospital), Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WeiLie","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangzhou General Hospital of Guangzhou Military Command (Guangzhou Liuhuaqiao Hospital), Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"XiaoMing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangzhou General Hospital of Guangzhou Military Command (Guangzhou Liuhuaqiao Hospital), Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BangQi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Guangzhou General Hospital of Guangzhou Military Command (Guangzhou Liuhuaqiao Hospital), Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Bin","sequence":"additional","affiliation":[{"name":"Department of Oncology, Guangzhou General Hospital of Guangzhou Military Command (Guangzhou Liuhuaqiao Hospital), Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"9146","key":"i0020-8868-97-2-104-Lim1","series-title":"Lancet","first-page":"40","article-title":"Potentially high prevalence of primary aldosteronism in a primary-care population.","volume":"353","author":"Lim\n              PO","year":"1999","unstructured":"Lim\n              PO\n            , RodgersP, CardaleK, WatsonAD, and MacDonaldTM. Potentially high prevalence of primary aldosteronism in a primary-care population.Lancet1999. 353 (9146):40."},{"issue":"5","key":"i0020-8868-97-2-104-Fardella1","series-title":"J Clin Endocrinol Metab","first-page":"1863","article-title":"Primary hyperaldosteronism in essential hypertensives: prevalence, biochemical profile, and molecular biology.","volume":"85","author":"Fardella\n              CE","year":"2000","unstructured":"Fardella\n              CE\n            , MossoL, G\u00f3mez-S\u00e1nchezC, Cort\u00e9sP, SotoJ, G\u00f3mezL, et al. Primary hyperaldosteronism in essential hypertensives: prevalence, biochemical profile, and molecular biology.J Clin Endocrinol Metab2000. 85 (5):1863\u20131867."},{"issue":"2","key":"i0020-8868-97-2-104-Fogari1","series-title":"Hypertens Res","first-page":"111","article-title":"Prevalence of primary aldosteronism among unselected hypertensive patients: a prospective study based on the use of an aldosterone\/renin ratio above 25 as a screening test.","volume":"30","author":"Fogari\n              R","year":"2007","unstructured":"Fogari\n              R\n            , PretiP, ZoppiA, RinaldiA, FogariE, and MugelliniA. Prevalence of primary aldosteronism among unselected hypertensive patients: a prospective study based on the use of an aldosterone\/renin ratio above 25 as a screening test.Hypertens Res2007. 30 (2):111\u2013117."},{"issue":"8","key":"i0020-8868-97-2-104-Milliez1","series-title":"J Am Coll Cardiol","first-page":"1243","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism.","volume":"45","author":"Milliez\n              P","year":"2005","unstructured":"Milliez\n              P\n            , GirerdX, PlouinPF, BlacherJ, SafarME, and MouradJJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism.J Am Coll Cardiol2005. 45 (8):1243\u20131248."},{"issue":"2","key":"i0020-8868-97-2-104-Fallo1","series-title":"J Clin Endocrinol Metab","first-page":"454","article-title":"Prevalence and characteristics of the metabolic syndrome in primary aldosteronism.","volume":"91","author":"Fallo\n              F","year":"2006","unstructured":"Fallo\n              F\n            , VeglioF, BertelloC, SoninoN, Della MeaP, ErmaniM, et al. Prevalence and characteristics of the metabolic syndrome in primary aldosteronism.J Clin Endocrinol Metab2006. 91 (2):454\u2013459."},{"issue":"5","key":"i0020-8868-97-2-104-Walz1","series-title":"World J Surg","first-page":"847","article-title":"Retroperitoneoscopic adrenalectomy in Conn's syndrome caused by adrenal adenomas or nodular hyperplasia.","volume":"32","author":"Walz\n              MK","year":"2008","unstructured":"Walz\n              MK\n            , GwosdzR, LevinSL, AlesinaPF, SuttorpAC, MetzKA, et al. Retroperitoneoscopic adrenalectomy in Conn's syndrome caused by adrenal adenomas or nodular hyperplasia.World J Surg2008. 32 (5):847\u2013853."},{"issue":"2","key":"i0020-8868-97-2-104-Meyer1","series-title":"World J Surg","first-page":"155","article-title":"Long-term follow-up after adrenalectomy for primary aldosteronism.","volume":"29","author":"Meyer\n              A","year":"2005","unstructured":"Meyer\n              A\n            , BrabantG, and BehrendM. Long-term follow-up after adrenalectomy for primary aldosteronism.World J Surg2005. 29 (2):155\u2013159."},{"issue":"1-2","key":"i0020-8868-97-2-104-Nejatizadeh1","series-title":"Clin Biochem","first-page":"136","article-title":"CYP11B2 gene haplotypes independently and in concurrence with aldosterone and aldosterone to renin ratio increase the risk of hypertension.","volume":"43","author":"Nejatizadeh\n              A","year":"2010","unstructured":"Nejatizadeh\n              A\n            , KumarR, StobdanT, GoyalAK, GuptaM, TyagiS, et al. CYP11B2 gene haplotypes independently and in concurrence with aldosterone and aldosterone to renin ratio increase the risk of hypertension.Clin Biochem2010. 43 (1-2):136\u2013141."},{"issue":"12","key":"i0020-8868-97-2-104-vanRijnBikker1","series-title":"Am J Hypertens","first-page":"1295","article-title":"Genetic factors are relevant and independent determinants of antihypertensive drug effects in a multiracial population.","volume":"22","author":"van Rijn-Bikker\n              PC","year":"2009","unstructured":"van Rijn-Bikker\n              PC\n            , MairuhuG, van MontfransGA, et al. Genetic factors are relevant and independent determinants of antihypertensive drug effects in a multiracial population.Am J Hypertens2009. 22 (12):1295\u20131302."},{"issue":"6","key":"i0020-8868-97-2-104-Isaji1","series-title":"J Hypertens","first-page":"1149","article-title":"Correlation between left ventricular mass and urinary sodium excretion in specific genotypes of CYP11B2.","volume":"23","author":"Isaji\n              M","year":"2005","unstructured":"Isaji\n              M\n            , MuneT, TakadaN, YamamotoY, SuwaT, MoritaH, et al. Correlation between left ventricular mass and urinary sodium excretion in specific genotypes of CYP11B2.J Hypertens2005. 23 (6):1149\u20131157."},{"issue":"10","key":"i0020-8868-97-2-104-Strauch1","series-title":"Am J Hypertens","first-page":"1086","article-title":"Adrenalectomy improves arterial stiffness in primary aldosteronism.","volume":"21","author":"Strauch\n              B","year":"2008","unstructured":"Strauch\n              B\n            , Petr\u00e1kO, ZelinkaT, WichterleD, HolajR, Kasalick\u00fdM, et al. Adrenalectomy improves arterial stiffness in primary aldosteronism.Am J Hypertens2008. 21 (10):1086\u20131092."},{"issue":"2","key":"i0020-8868-97-2-104-Tuck1","series-title":"Curr Hypertens Rep","first-page":"87","article-title":"Renal damage in primary aldosteronism: results of the PAPY study.","volume":"9","author":"Tuck\n              ML","year":"2007","unstructured":"Tuck\n              ML\n             and CorryDB. Renal damage in primary aldosteronism: results of the PAPY study.Curr Hypertens Rep2007. 9 (2):87\u201389."},{"issue":"12","key":"i0020-8868-97-2-104-Sywak1","series-title":"Br J Surg","first-page":"1587","article-title":"Long-term follow-up and cost benefit of adrenalectomy in patients with primary hyperaldosteronism.","volume":"89","author":"Sywak\n              M","year":"2002","unstructured":"Sywak\n              M\n             and PasiekaJL. Long-term follow-up and cost benefit of adrenalectomy in patients with primary hyperaldosteronism.Br J Surg2002. 89 (12):1587\u20131593."},{"issue":"3","key":"i0020-8868-97-2-104-Zarnegar1","series-title":"Ann Surg","first-page":"511","article-title":"The aldosteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma.","volume":"247","author":"Zarnegar\n              R","year":"2008","unstructured":"Zarnegar\n              R\n            , YoungWFJr, LeeJ, SweetMP, KebebewE, FarleyDR, et al. The aldosteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma.Ann Surg2008. 247 (3):511\u2013518."},{"issue":"7","key":"i0020-8868-97-2-104-Kim1","series-title":"J Korean Med Sci","first-page":"1041","article-title":"Predictors of resolution of hypertension after adrenalectomy in patients with aldosterone-producing adenoma.","volume":"25","author":"Kim\n              RM","year":"2010","unstructured":"Kim\n              RM\n            , LeeJ, and SohEY. Predictors of resolution of hypertension after adrenalectomy in patients with aldosterone-producing adenoma.J Korean Med Sci2010. 25 (7):1041\u20131044."},{"issue":"3","key":"i0020-8868-97-2-104-Arlt1","series-title":"Eur J Endocrinol","first-page":"435","article-title":"A detour guide to the Endocrine Society Clinical Practice Guideline on case detection, diagnosis and treatment of patients with primary aldosteronism.","volume":"162","author":"Arlt\n              W","year":"2010","unstructured":"Arlt\n              W\n            \n          . A detour guide to the Endocrine Society Clinical Practice Guideline on case detection, diagnosis and treatment of patients with primary aldosteronism.Eur J Endocrinol2010. 162 (3):435\u2013438."},{"issue":"2","key":"i0020-8868-97-2-104-Gockel1","series-title":"Am Surg","first-page":"174","article-title":"Long-term results of endoscopic adrenalectomy for Conn's syndrome.","volume":"73","author":"Gockel\n              I","year":"2007","unstructured":"Gockel\n              I\n            , HeintzA, PoltaM, and JungingerT. Long-term results of endoscopic adrenalectomy for Conn's syndrome.Am Surg2007. 73 (2):174\u2013180."},{"issue":"2","key":"i0020-8868-97-2-104-Rossi1","series-title":"Endocrinol Metab Clin North Am","first-page":"313","article-title":"Diagnosis and treatment of primary aldosteronism.","volume":"40","author":"Rossi\n              GP","year":"2011","unstructured":"Rossi\n              GP\n            \n          . Diagnosis and treatment of primary aldosteronism.Endocrinol Metab Clin North Am2011. 40 (2):313\u2013332."},{"issue":"6","key":"i0020-8868-97-2-104-Zarnegar2","series-title":"Surgery","first-page":"921","article-title":"Good blood pressure control on antihypertensives, not only response to spironolactone, predicts improved outcome after adrenalectomy for aldosteronoma.","volume":"142","author":"Zarnegar\n              R","year":"2007","unstructured":"Zarnegar\n              R\n            , LeeJ, BrunaudL, LindsayS, KebebewE, ClarkOH, et al. Good blood pressure control on antihypertensives, not only response to spironolactone, predicts improved outcome after adrenalectomy for aldosteronoma.Surgery2007. 142 (6):921\u2013929."},{"issue":"2","key":"i0020-8868-97-2-104-Bassett1","series-title":"J Mol Endocrinol","first-page":"125","article-title":"Differential regulation of aldosterone synthase and 11b-hydroxylase transcription by steroidogenic factor-1.","volume":"28","author":"Bassett\n              MH","year":"2002","unstructured":"Bassett\n              MH\n            , ZhangY, ClyneC, WhitePC, and RaineyWE. Differential regulation of aldosterone synthase and 11b-hydroxylase transcription by steroidogenic factor-1.J Mol Endocrinol2002. 28 (2):125\u2013135."},{"issue":"3","key":"i0020-8868-97-2-104-Ye1","series-title":"Endocrinology","first-page":"1303","article-title":"Differential effects of high and low steroidogenic factor-1 expression on CYP11B2 expression and aldosterone production in adrenocortical cells.","volume":"150","author":"Ye\n              P","year":"2009","unstructured":"Ye\n              P\n            , NakamuraY, LalliE, and RaineyWE. Differential effects of high and low steroidogenic factor-1 expression on CYP11B2 expression and aldosterone production in adrenocortical cells.Endocrinology2009. 150 (3):1303\u20131309."},{"issue":"6","key":"i0020-8868-97-2-104-Proye1","series-title":"Surgery","first-page":"1128","article-title":"Essential hypertension: first reason for persistent hypertension after unilateral adrenalectomy for primary aldosteronism?","volume":"124","author":"Proye\n              CA","year":"1998","unstructured":"Proye\n              CA\n            , MulliezEA, CarnailleBM, Lecomte-HouckeM, DecoulxM, W\u00e9meauJL, et al. Essential hypertension: first reason for persistent hypertension after unilateral adrenalectomy for primary aldosteronism?Surgery1998. 124 (6):1128\u20131133."},{"issue":"6","key":"i0020-8868-97-2-104-Celen1","series-title":"Arch Surg","first-page":"646","article-title":"Factors influencing outcome of surgery for primary aldosteronism.","volume":"131","author":"Celen\n              O","year":"1996","unstructured":"Celen\n              O\n            , O'BrienMJ, MelbyJC, and BeazleyRM. Factors influencing outcome of surgery for primary aldosteronism.Arch Surg1996. 131 (6):646\u2013650."},{"issue":"5","key":"i0020-8868-97-2-104-Rossi2","series-title":"Hypertension","first-page":"1366","article-title":"Vascular remodeling and duration of hypertension predict outcome of adrenalectomy in primary aldosteronism patients.","volume":"51","author":"Rossi\n              GP","year":"2008","unstructured":"Rossi\n              GP\n            , BolognesiM, RizzoniD, SecciaTM, PivaA, PorteriE, et al. Vascular remodeling and duration of hypertension predict outcome of adrenalectomy in primary aldosteronism patients.Hypertension2008. 51 (5):1366\u20131371."},{"issue":"9628","key":"i0020-8868-97-2-104-Douma1","series-title":"Lancet","first-page":"1921","article-title":"Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study.","volume":"371","author":"Douma\n              S","year":"2008","unstructured":"Douma\n              S\n            , PetidisK, DoumasM, PapaefthimiouP, TriantafyllouA, KartaliN, et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study.Lancet2008. 371 (9628):1921\u20131926."},{"issue":"3","key":"i0020-8868-97-2-104-Rossi3","series-title":"J Hypertens","first-page":"656","article-title":"Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma.","volume":"27","author":"Rossi\n              GP","year":"2009","unstructured":"Rossi\n              GP\n             and PessinaAC. Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma.J Hypertens2009. 27 (3):656\u2013657."},{"issue":"2","key":"i0020-8868-97-2-104-Gaddam1","series-title":"Curr Probl Cardiol","first-page":"51","article-title":"Aldosterone and cardiovascular disease.","volume":"34","author":"Gaddam\n              KK","year":"2009","unstructured":"Gaddam\n              KK\n            , PimentaE, HusainS, and CalhounDA. Aldosterone and cardiovascular disease.Curr Probl Cardiol2009. 34 (2):51\u201384."},{"issue":"1","key":"i0020-8868-97-2-104-Zarnegar3","series-title":"J Vasc Interv Radiol","first-page":"66","article-title":"Is adrenal venous sampling necessary in all patients with hyperaldosteronism before adrenalectomy?","volume":"19","author":"Zarnegar\n              R","year":"2008","unstructured":"Zarnegar\n              R\n            , BloomAI, LeeJ, KerlanRKJr, WilsonMW, LabergeJM, et al. Is adrenal venous sampling necessary in all patients with hyperaldosteronism before adrenalectomy?J Vasc Interv Radiol2008. 19 (1):66\u201371."},{"issue":"5","key":"i0020-8868-97-2-104-Tan1","series-title":"World J Surg","first-page":"879","article-title":"Selective use of adrenal venous sampling in the lateralization of aldosterone-producing adenomas.","volume":"30","author":"Tan\n              YY","year":"2006","unstructured":"Tan\n              YY\n            , OgilvieJB, TriponezF, CaronNR, KebebewEK, ClarkOH, et al. Selective use of adrenal venous sampling in the lateralization of aldosterone-producing adenomas.World J Surg2006. 30 (5):879\u2013885."},{"issue":"4","key":"i0020-8868-97-2-104-Toniato1","series-title":"World J Surg","first-page":"624","article-title":"The role of adrenal venous sampling in the surgical management of primary aldosteronism.","volume":"30","author":"Toniato\n              A","year":"2006","unstructured":"Toniato\n              A\n            , BernanteP, RossiGP, and PelizzoMR. The role of adrenal venous sampling in the surgical management of primary aldosteronism.World J Surg2006. 30 (4):624\u2013627."}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/97\/2\/article-p104.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/97\/2\/104\/2213927\/cc140_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/97\/2\/article-p104.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/97\/2\/article-p104.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:04:33Z","timestamp":1751483073000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/97\/2\/article-p104.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.9738\/cc140.1","relation":{},"ISSN":["0020-8868","2520-2456"],"issn-type":[{"type":"print","value":"0020-8868"},{"type":"electronic","value":"2520-2456"}],"subject":[],"published":{"date-parts":[[2012,10]]}}}