Overview of endocrine hypertension treated in surgery at Chris Hani Baragwanath Academic Hospital

Résumé

Introduction. The endocrine hypertension is believed to be underestimated worldwide especially in the developing world. There is scarcity of publications on endocrine hypertension in Sub-Saharan Africa. The aim of this study is to reflect on the profile of patients with endocrine hypertension at Chris Hani Baragwanath Academic Hospital (CHBAH) in Johannesburg, South Africa

Objectives. To determine the etiologies, the lead time to diagnosis of endocrine hypertension and to reflect on the surgical approach and outcome thereof. 

Methods. Descriptive observational study of all surgical procedures performed at CHBAH from January 2013 to December 2020. Parameters analysed included the demographics, the etiologies, the location of the disease, the surgical approach, the histopathology, the incidence of malignancy, the lead time and the 30 days outcome.

Results. Of the 47 patients analyzed, there were 66% female and 34% male. The mean age was 38 years. The majority of the cases were due to catecholamines secreting tumours (60%). Overall, 47% of procedure were completed laparoscopically. Altogether, the known mean lead time was longer ranging from 5 to 12 years. The incidence of malignancy was 15% and the 30 days mortality was 4%. The complications of hypertension contributed in the diagnosis of 8.5% of cases.

Conclusion. The catecholamines producing tumours were the most common. Laparoscopy was successful in 47%. The lead time was longer and there were more tumours located on the left side. There were 4.0% mortality.  

Recommendation: to selectively screen the newly diagnosed hypertension, the pantient on 3 or more anti-hypertensive medication and the young hypertensive patients.