Robotic partial adrenalectomy for aldosterone secreting adenomas: initial report from two tertiary referral centers
In the era of minimally invasive surgery, partial adrenalectomy has been certainly underused. We aimed to report
on postoperative and early functional outcomes of a two-center robotic partial adrenalectomy (RPA) series.
Materials and Methods
From June 2014 to June 2017 RPA was performed on 10 consecutive patients affected by aldosterone-secreting adenomas. Preoperative,
postoperative and early functional outcomes data were prospectively collected and reported.
All cases were completed robotically. Median nodule size was 18,1 mm (range 10-30) (Table 1). Intraoperative blood loss was negligible,
postoperative course was uneventful in 9 cases; a single (10%) postoperative Clavien grade 2 complication occurred (fever requiring antibiotics); mean hospital
stay was 3,6 days (range 2-13). Patients became normotensive immediately after surgery (mean preoperative blood pressure: 152/93 mmHg; mean postoperative
blood pressure: 120/71 mmHg, respectively). None of the patients required further hypotensive treatment (Table 2).
Aldosterone and plasmatic renin activity (PRA) levels decreased and returned within the normal range after surgery (mean post-operative aldosterone: 152 pg/ml [
normal range: 17.6-232] and mean post-operative PRA:2.4 ng/ml h [range: 0.2â€“2.8], respectively). At one-yr follow-up, all patients were normotensive and
hypotensive treatment free.
In the era of minimally invasive surgery, partial adrenalectomy has been certainly underused, and adrenal masses are treated through robotic total adrenalectomy . We reported safety and feasibility of robotic partial adrenalectomy for patients with aldosterone-secreting adenomas.
RPA is a safe, feasible and minimally invasive surgical approach. The excellent perioperative and early functional outcomes suggest
an increasing adoption of this technique in the near future.
1. Robotic assisted adrenalectomy: Surgical techniques, feasibility, indications, oncological outcome and safety.
Int J Surg. 2016 Apr;28:169-72. doi: 10.1016/j.ijsu.2016.02.089. Epub 2016 Feb 27. Review