Ultrasound-guided radiofrequency ablation versus laparoscopic adrenalectomy for unilateral isolated aldosterone-producing adenoma: a two-center retrospective study.

OBJECTIVE: This study aimed to evaluate the safety and efficacy of Ultrasound-guided radiofrequency ablation (US-guided RFA) compared to laparoscopic adrenalectomy (LA) for the treatment of aldosterone-producing adenoma (APA). METHODS: This retrospective, two-center study evaluated 100 patients with APA treated with either US-guided RFA or LA between January 2020 and June 2024. Patients were categorized based on treatment modality (US-guided RFA: n=36; LA: n=64). To minimize confounding, a 1:1 matching was performed based on sex, age, medical history, and disease characteristics. Post-treatment outcomes, including biochemical remission and blood pressure control, were compared using independent-samples t-tests or chi-square tests. RESULTS: A total of 36 patients (median age: 49.5 years [IQR: 33.25-57.00]; 23 women) underwent US-guided RFA, and 36 matched patients (median age: 52.00 years [IQR: 37.50-59.75]; 20 women) underwent LA. The technical success rate was 100% in both groups. During the follow-up period (median: 14 months [IQR: 6-22 months]), both groups achieved complete biochemical remission (36/36, P = 1.000), similar hypertension control rates (66.7% vs. 77.8%, P = 0.430), and no disease progression (0/36 in both groups). US-guided RFA was associated with significantly lower intraoperative blood loss (median: 3.0 mL vs. 30 mL) and shorter procedure time (77.5 min vs. 115 min; both P < 0.001). CONCLUSION: In patients with unilateral isolated APA, no significant differences were observed between US-guided RFA and LA in terms of disease progression, biochemical remission, or hypertension control in the short term.