摘要
目的总结后腹腔镜肾上腺肿瘤切除的方法及临床应用价值。方法对2000年12月至2008年12月我院行腹腔镜肾上腺手术的210例患者的临床资料进行回顾性分析。本组患者术前均经超声、CT或MRI等证实为肾上腺占位性病变。病变位于右侧117例,左侧85例,双侧8例。原发性醛固酮增多症81例,皮质醇增多症52例,嗜铬细胞瘤19例,无功能腺瘤40例,其他18例。瘤体直径1.2～7.5 cm,平均3.0 cm。结果11例因出血而中转开放手术,其余均在腹腔镜下完成手术。手术时间38～300 min,平均98 min;出血量20～1 200 mL,平均48 mL,术后住院时间4～28 d,平均7.1 d,1例嗜铬细胞瘤患者术后2 d死于继发出血。术中下腔静脉破裂2例,均在腹腔镜下完成修补。168例随访2～72个月,平均14个月,无远期并发症。结论后腹腔镜肾上腺肿瘤切除术对最大径<6 cm的肾上腺肿瘤安全、有效、创伤少、出血少、术后恢复快。
Objective To explore the value and efficacy of retroperitoneal laparoscopic adrenalectomy（RLA）. Methods From December 2000 to December 2008, a total of 210 cases diagnosed of occupation of adrenal gland by ultra-sound,CT or MRI underwent RLA in our hospital. There were 123 males and 87 females（19-69 years）. The tumors were on the rigllt side in 117 cases, on the left side in 85 cases and on both sides in the other 8 cases. Of all 210 cases, hyperal- dosteronism was detected in 81, Cushing＇s syndrome in 52, nonfunctioning adenoma in 40, pbeochromocytoma in 19, and the other diseases in 10. The size of the tumors ranged from 1.2 to 7.5cm. Results RLA were performed successfully in 119 patients, and the other 11 were converted to open surgery due to hemorrhage. The operative time ranged from 38 to 300min with a mean of 98 min. The blood loss was 20 - 1200 ml with a mean of 48mL;The mean postoperative hospital stay was 7.1 days（4-28）. One pheochromocytoma patient died from secondary hemorrhage two days after operation. The rapture of the inferior vena cava occurred in two cases, and was repaired under a laparoscope. Follow-up was available for up to 2 to 72 months （a mean of 24） in 168 patients; no patient had long term complication. Conclusion RLA is a safe and effec- tive procedure with less invasion and blood loss and a short convalescence in adrenal tumors whose maximum diameters are less than 6cm.
出处
《微创医学》
2009年第2期104-106,共3页
Journal of Minimally Invasive Medicine
关键词
后腹腔镜肾上腺切除术
肾上腺肿瘤
Retroperitoneal laparoscopic adrenalectomy
Adrenal tumor
