Following unilateral adrenalectomy for primary hyperaldosteronism caused by an adenoma, patients normally do not require corticosteroid or electrolyte replacement. There is usually minimal blood loss during and after the operation, and postoperative fluid imbalances are usually not severe.12 A rare patient will experience transient aldosterone deficiency following adrenalectomy if the normal contralateral adrenal gland was suppressed by the adenoma; this can be corrected with administration of exogenous aldosterone (fludrocortisone 0.1 mg/d orally). Most patients who have been well prepared with spironolactone prior to operation need to stay in the hospital only overnight.
The majority of patients who undergo adrenalectomy for the treatment of primary hyperaldosteronism will correct their blood pressure and electrolyte abnormalities.6'7'12'13 Hypertension may not correct immediately and, in some cases, may persist for a year or more following operation before becoming normal. In our recent series, 88% of patients became nor-motensive following operation and did not require antihypertensive medications.6 Serum potassium values were normal and ranged from 3.5 to 4.9 mg/dL following operation in this series of patients.
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