Experience of a tertiary/quaternary unit with surgery for endocrine hypertension

Endocrine hypertension is believed to be underestimated worldwide especially in the developing countries. There is a scarcity of publications on endocrine hypertension in sub-Saharan Africa. The aim of this study was to reflect the profile of patients with endocrine hypertension of adrenal/paraganglioma origin at Chris Hani Baragwanath Academic Hospital (CHBAH). The objective was to determine the aetiology, the lead time to diagnosis of endocrine hypertension and to reflect on the surgical approach and outcome.

This descriptive observational study reviewed all surgical procedures performed at CHBAH from 1 January 2013 to 31 December 2020. Parameters analysed included the demographics, the aetiologies, the location of the disease, the surgical approach, the histopathology, the incidence of malignancy, the lead time and the 30-days outcome.

Of the 44 patients analysed, there were 66% female and 34% male. The mean age was 38 years. The majority of the cases were due to catecholamine secreting tumours (65.9%). Overall, 43.1% of the procedures were completed laparoscopically. Altogether, the mean lead time ranged from 5 to 12 years. The incidence of malignancy and the 30-day mortality were 15.9% and 4.5% respectively. The index presentation of endocrine hypertension was due to complications in 9% of the cases.

Catecholamine producing tumours were the most common aetiology. Laparoscopy was successful in 43.1%. The lead time was long and there were more tumours on the left side. The mortality rate was 4.5%.