摘要
目的:评价腹腔镜切除长径5～9cm肾上腺肿瘤的安全性。方法:回顾性分析1995～2004年行开放或腹腔镜肾上腺肿瘤切除术的41例病例资料,比较2组患者围手术期临床资料。结果:腹腔镜组与开放手术组相比,术中输血率(10.0%∶33.3%,P<0.05)、术后进食活动时间(2.10d∶3.28d,P<0.01)和术后住院时间(6.90d∶9.76d,P<0.001)均优于开放手术组,差异有统计学意义。2组在手术时间(151.0min∶133.83min)、术中出血量(312.5ml∶391.3ml)、术后入ICU率(40.0%∶46.7%)、术后拔除引流管时间(3.1d∶3.5d)、引流量(215.3ml∶220.7ml)、术后输血率(10.0%∶6.7%)、症状缓解率(80.0%∶77.8%)、手术并发症发生率(9.1%∶10.0%)和住院费用(16822.10元∶17247.10元)方面的差异无统计学意义(P>0.05)。结论:对于有丰富腹腔镜手术经验者,较大肾上腺肿瘤(长径5～9cm)不再是绝对禁忌症。经过精心挑选的患者,通过认真的术前准备,行腹腔镜较大肾上腺肿瘤切除术是安全有效的。
To observe the clinical safety of laparoscopic adrenalectomy （LA） for larger adrenal tumors （Long diameter 5-9 cm）. Methods：41 open adrenalectomies and LAs were performed for patients with larger adrenal tumors （Long diameter 5-9 cm） in Department of Urology, Peking University First Hospital from 1995 to 2004. The perioperative clinical data were analyzed retrospectively. Results：The LAs group had lower rate of blood transfusion during operation （10. 0% ： 33.3% ,P〈0. 05）, shorter time to take food and walk after operation （2.10d ： 3.28 d,P〈0.01） and shorter time to stay in hospital after operation （6.90 d ： 9.76 d,P〈 0. 001） than the open group. There were no significant differences between two groups for the operation time （151.0 min ： 133. 83 min, P〉0. 05）, the blood loss during operation （312. 5 ml ： 391.3 ml, P〉0. 05）, the patient percentage to enter into ICU （40. 0% ： 46.7%, P〉0. 05）, the time to pull out the drainage tube after operation （3.1 d ： 3.5 d, P〉0. 05）, the drainage volume （215.3 ml ： 220.7 ml, P〉0.05）, the blood transfusion rate after operation （10. 0% ： 6.7%, P〉0.05）, the dosage of analgesic drugs used after operation （P〉0.05）, the rate of symptomatic relief after operation （80.0% ： 77.8%, P〉0.05） and the cost of hospitalization （16 822.10 RMB ： 17 247.10 RMB, P〉0.05）. The complication rates for two groups were 9.1%（1/11） and 10. 0% （3/30） respectively （P〉0.05）. Conclusions：The larger size of adrenal tumors is not absolute contraindication of LAs for experienced endourologists. Larger adrenal tumors （long diameter 5-9 cm） can be performed by lanaroscopic method safelv and effectivelv for selected patients after sufficient PreoPerative PreParation.
出处
《临床泌尿外科杂志》
2007年第8期565-567,共3页
Journal of Clinical Urology
