摘要
目的评价后腹腔镜肾上腺切除治疗嗜铬细胞瘤的临床价值。方法对本院2000年2月～2008年12月25例后腹腔镜治疗肾上腺嗜铬细胞瘤的临床资料进行回顾性分析。左侧15例，右侧10例，肿瘤直径3．0～5．6cm，平均4．2cm。结果除3例因出血和肿瘤粘连严重中转开放手术外，其余22例均成功切除肿瘤。手术时间67—210min，平均123min；手术出血量50～450mL，平均120mL；术中下腔静脉破裂2例，均在腹腔镜下完成修补；1例术后24小时死于继发出血。术后病理诊断24例为良性肾上腺嗜铬细胞瘤，1例为低度恶性肾上腺嗜铬细胞瘤。术后住院时间8—20天，平均12天。随访5～36个月，平均12个月，除1例需口服降压药外，其余血压恢复正常，24小时尿VMA检查正常，无远期并发症，未见肿瘤复发。结论后腹腔镜肾上腺肿瘤切除术对最大径〈6cm肾上腺嗜铬细胞瘤安全、有效、创伤少、出血少、恢复快。术前准备和术后处理在治疗嗜铬细胞瘤的过程中具有重要价值。
Objectives To evaluate the efficacy of retroperitoneoscopic adrenalectomy for pheochromocytoma. Methods From February 2000 to December 2008, a total of 25 patients with pheochromocytoma received retroperitoneoscopic adrenalectomy in our hospital. Among the cases,15 had the tumor on the left side, and 10 on the right. The size of the tumors ranged, from 3.0 to 5.6 cm in diameter （ mean, 4.2 cm ）. Results The retroperitoneoscopic adrenalectomy was completed in 22 cases, three of the patients, who were converted to open surgery because of extensive adhesion of the tumor to surrounding tissues and massive bleeding. The operative time was 67 - 210min with a mean of 123min ;The blood loss was 50 -450mL with a mean of 120mL;The rupture of the inferior vena cava occurred in two cases, and was repaired under a laparoscope. One pheochromocytoma was died from secondary hemorrhage in 24hours of operation. Postoperative examination showed benign pheochromocytoma in 24 of the cases,and the other one showed low - grade malignant pheochromocytoma. The mean postoperative hospital stay was 12days （8 - 20）. The patients were followed up for 5 to 36months （mean, 12 ）, during which only one received antihyperiensive drugs;the other restored normal blood pressure spontaneously;none of them had long - term complication or recurrent. Conclusions Retroperitoneal Laparoscopic Adrenalectomy （RLA） is a safe and effective procedure with less invasion and blood loss, a short convalescence in the pheochromocytoma whose maximum diameters are less than 6cm. Preoperative preparation and postoperative treatment are important for the outcomes of the disease.
出处
《国际泌尿系统杂志》
2009年第3期303-306,共4页
International Journal of Urology and Nephrology
关键词
嗜铬细胞瘤
肾上腺肿瘤
外科手术
腹腔镜
Pheochromocytoma
Adrenal Gland Neoplasms
Surgical Procedures, Laparoscopic
