Preliminary study of laparoscopic radiofrequency ablation of sympathetic nerve in the renal artery for refractory hypertension

doi:10.3877/cma.j.issn.1674-3253.2025.06.009

Abstract

Abstract:

Objective

To investigate the safety and efficacy of laparoscopic radiofrequency ablation of the sympathetic nerve in the adventitia of the renal artery for refractory hypertension.

Methods

Five patients with refractory hypertension in the Second Affiliated Hospital of Soochow University from 2021 to 2024, laparoscopic radiofrequency ablation of renal artery adventitial sympathetic nerve was performed after operator evaluation: laparoscopic retroperitoneal approach, radiofrequency ablation catheter after freeing renal artery, annular ablation along the renal artery wall, radiofrequency lasting for about 10 seconds each time. Postoperative regular follow-up, pay close attention to the complication rate and blood pressure changes.

Results

The age of 5 patients was 18-75 years, of which 4 males and 1 female were diagnosed essential hypertension after perfecting the relevant examination. One patient underwent laparoscopic unilateral adrenal tumor resection combined with sympathetic radiofrequency ablation of the renal artery; the remaining four patients underwent laparoscopic bilateral sympathetic radiofrequency ablation of the renal artery. All 5 patients successfully completed the operation and the follow-up ranged from 1 month to 2 years, and the postoperative pathology of patient with unilateral adrenal tumor resection indicated nonfunctional adenoma. All five patients showed significant improvement in postoperative blood pressure without significant complications.

Conclusion

Laparoscopic sympathetic radiofrequency ablation of renal arteries provides a new exploration for the treatment of refractory hypertension.

Key words: Hypertension, refractory, Laparoscopy, Radiofrequency ablation, Renal denervation, Sympathetic nerve system

Yang Wang, Zhihang Ni, Chunlai Shao, Boxin Xue, Xiaolong Liu. Preliminary study of laparoscopic radiofrequency ablation of sympathetic nerve in the renal artery for refractory hypertension[J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(06): 742-746.

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References 24

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编号	性别	年龄（岁）	术前血压（mmHg）	吸烟史	高血压家族史	高血压病程（年）	糖尿病病史	慢性肾脏病病史
1	男	75	175/95	是	是	10	否	否
2	男	45	180/125	是	是	5	否	是
3	女	45	170/100	否	否	3	否	否
4	男	65	186/92	是	是	30	是	是
5	男	18	150/87	否	是	5	否	否

编号	性别	年龄（岁）	术前血压（mmHg）	吸烟史	高血压家族史	高血压病程（年）	糖尿病病史	慢性肾脏病病史
1	男	75	175/95	是	是	10	否	否
2	男	45	180/125	是	是	5	否	是
3	女	45	170/100	否	否	3	否	否
4	男	65	186/92	是	是	30	是	是
5	男	18	150/87	否	是	5	否	否

编号	手术时间（h）	出血量（ml）	术后下床时间（d）	住院天数（d）
1	3.0	50	1	12
2	3.5	20	1	7
3	3.6	<10	1	10
4	4.0	<10	1	7
5	4.0	30	1	7

编号	手术时间（h）	出血量（ml）	术后下床时间（d）	住院天数（d）
1	3.0	50	1	12
2	3.5	20	1	7
3	3.6	<10	1	10
4	4.0	<10	1	7
5	4.0	30	1	7

编号	血浆肾素活性(ng/mL/h)		ACTH (pg/mL)		血浆醛固酮浓度(pg/mL)		皮质醇(ng/dL)		血钾(mmol/L)		血肌酐(μmol/L)
编号	术前	术后	术前	术后	术前	术后	术前	术后	术前	术后	术前	术后
1	1.78	2.82	13.12	39.85	98.90	46.60	9.13	19.83	3.24	4.75	82	63
2	24.36	31.29	48.75	43.91	121.53	139.13	11.86	11.39	4.30	5.20	1 595	1 226
3	16.10	17.66	44.72	43.67	80.91	78.49	6.12	5.89	4.58	4.75	110	109
4	51.09	56.70	54.61	32.21	35.33	64.11	8.11	11.81	4.75	4.13	811	691
5	50.30	10.20	54.80	20.90	24.00	22.80	13.80	7.40	4.00	4.15	66	73

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