Summary
The objective was to determine the clinical and biochemical success rates and assess
the nature of follow-up after adrenalectomy in patients with unilateral primary aldosteronism
(PA), subtyped by adrenal vein sampling (AVS) in West Australia (WA) using the Primary
Aldosteronism Surgical Outcome (PASO) criteria. Clinical and biochemical outcomes
were retrospectively evaluated in patients with unilateral PA who underwent adrenalectomy
according to AVS between September 2017 and September 2020. Pre- and post-surgical
data were collected using a standardised questionnaire, review of clinic letters and
examination of private and public pathology results and radiological reports. Follow-up
data were available for 47 patients post-adrenalectomy; biochemical outcome data were
available for 37 patients, clinical outcome data for 40 patients, with 30 patients
having both outcomes available. Final assessment was performed between 0 to 3 months
in 23/37 (62.2%) patients with biochemical outcomes, 15/40 (37.5%) with clinical outcomes,
and 17/30 (56.7%) with both clinical and biochemical outcomes. Complete biochemical
success was achieved in 83.8% (31/37) of patients, with 26.7% (8/30) obtaining both
complete clinical and biochemical success. Complete clinical success was achieved
in 35.0% (14/40) of patients, with 47.5% (19/40) obtaining partial clinical success.
Overall, 93.6% (44/47) of patients derived benefit from adrenalectomy.
The outcomes of adrenalectomy for unilateral PA in Western Australian using standardised
PASO criteria demonstrate highly comparable clinical and biochemical success rates
to international data. However, further standardisation of post-operative follow-up
care needs to be implemented to ensure the recommended repeat follow-up assessment
criteria are collected.
Key words
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Article info
Publication history
Published online: April 14, 2023
Accepted:
February 22,
2023
Received in revised form:
February 8,
2023
Received:
December 23,
2022
Identification
Copyright
© 2023 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.
