Peri-Arterial Neural Dissection During Adrenal Surgery Provides a Denervation-Like Benefit in Hypertension Control

BACKGROUND: Peri-arterial neural tissue surrounding the renal artery contributes to sympathetic overactivity in hypertension. During adrenal surgery, surgical peri-arterial neural dissection may interrupt these fibers and exert a renal denervation-like effect. Whether this maneuver improves postoperative blood pressure control remains unclear. METHODS: We retrospectively reviewed 127 hypertensive patients who underwent adrenal surgery between January 2022 and March 2025. According to intraoperative findings, patients were classified into a surgical peri-arterial neural dissection group or a nondissection group. After 1:2 manual matching by age, sex, and hypertension duration, 54 patients were included. Postoperative hypertension remission and changes in antihypertensive medication use, quantified by the defined daily dose, were assessed. Multivariable logistic regression was used to explore factors associated with postoperative nonremission. Renal and adrenal function markers were compared between groups. RESULTS: =0.006). Creatinine, blood urea nitrogen, cortisol, and adrenocorticotropic hormone levels were similar between groups. CONCLUSIONS: Surgical peri-arterial neural dissection performed during adrenal surgery was associated with improved postoperative blood pressure control and reduced medication burden without evidence of impaired renal or adrenal function.