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CUHK Pioneers a Seamless Operation in the Treatment of
Conventionally this kind of secondary hypertension can be cured by surgical excisin of the affected adrenal gland. Laparoscopic adrenalectomy introduced in the last decade is currently the gold standard treatment for functional adrenal gland neoplasm. Though the procedure can be accomplished with minimal morbidity, it requires general anaesthesia and may result in serious complications. The operation often requires 3 to 4 incisions on the abdominal wall. The Faculty of Medicine of The Chinese University of Hong Kong has recently introduced a novel technique of treating the disorder. Since August 2004, 18 patients with secondary hypertension due to a functional adrenal tumour were treated by CT ¡Vguided radiofrequency ablation (RFA) under local anaesthesia in the Prince of Wales Hospital. The principle of RFA is the use of high frequency current delivered by an electrode to generate heat energy which destroys tissue in a predictable volume. Imaging guided RFA offers a minimally invasive approach to ablate neoplasm without external wound ¡V thus it is a kind of seamless operation. Our initial results of CT-guided RFA in functional adrenal gland neoplasm are encouraging. All patients have improvement of blood pressure control with 2/3 now completely drug-free. The serum aldosterone or cortisol levels as well as potassium concentration are normalized in all the 18 patients with an overall success rate of 94%. No major complication was noted with only one patient developing a peri-nephric haematoma. The median hospital stay after the procedure is 2 days and most patients were able to back to normal activity one day after the procedure. Our data suggest that RFA of functional adrenal neoplasm is an innovative, safe, seamless, and cost-effective measure for the treatment of this type of secondary hypertension. |