Abstract：
Primary aldosteronism (PA) is the most common cause of secondary hypertension and one of the few medical diseases that can be cured by surgery. Excessive aldosterone secretion is highly associated with cardiovascular complications. Many studies have shown that patients with unilateral PA treated with surgery have better survival, cardiovascular, clinical, and biochemical outcomes than those who receive medical treatment. Consequently, laparoscopic adrenalectomy is the gold standard for treating unilateral PA. Surgical methods should be individualized according to the patient\'s tumor size, body shape, surgical history, wound considerations, and surgeon\'s experience. Surgery can be performed through a transperitoneal or retroperitoneal approach, and via a single-port or multi-port laparoscopic approach. However, total or partial adrenalectomy remains controversial in treating unilateral PA. Partial excision will not completely eradicate the disease and is prone to recurrence. Mineralocorticoid receptor antagonists should be considered for patients with bilateral PA or patients who cannot undergo surgery. There are also emerging alternative interventions, including radiofrequency ablation and transarterial adrenal ablation, for which data on long-term outcomes are currently lacking. The Task Force of Taiwan Society of Aldosteronism developed these clinical practice guidelines with the aim of providing medical professionals with more updated information on the treatment of PA and improving the quality of care.
摘要：
原发性醛固酮增多症（PA）是继发性高血压的最常见原因，也是少数可以通过手术治愈的医学疾病之一。醛固酮分泌过多与心血管并发症高度相关。许多研究表明，手术治疗的单侧PA患者有更好的生存率，心血管,临床,和生化结果比接受药物治疗的人。因此,腹腔镜肾上腺切除术是治疗单侧PA的金标准。手术方法应根据患者的肿瘤大小进行个体化,身体形状,手术史,伤口注意事项,和外科医生的经验。手术可以通过腹膜或腹膜后入路进行，并通过单端口或多端口腹腔镜方法。然而,肾上腺全切除术或部分切除术在治疗单侧PA方面仍存在争议。部分切除不能完全根除疾病，容易复发。对于双侧PA患者或不能接受手术的患者，应考虑盐皮质激素受体拮抗剂。也有新兴的替代干预措施，包括射频消融和经动脉肾上腺消融，目前缺乏有关长期结果的数据。台湾醛固酮病学会专责小组制定了这些临床实践指南，旨在为医疗专业人员提供有关PA治疗的更多最新信息并提高护理质量。
