摘要
目的比较腹膜后腹腔镜肾上腺部分切除术与全切除术治疗肾上腺醛固酮瘤的治疗效果。方法回顾性分析我院94例醛固酮瘤临床资料。34例行后腹腔镜下肾上腺全切除术,60例行后腹腔镜下肾上腺部分切除术。术后随访6～60个月,平均24.5个月。结果行肾上腺全切组手术时间(40.0±12.0)min,术中失血量(23.5±9.5)ml,拔引流管时间(2.5±1.2)d,肿瘤大小(20.0±5.0)mm,术后住院天数(6.5±2.0)d。行肾上腺部分切除组手术时间(48.0±13.0)min,术中失血量(25.5±10.0)ml,拔引流管时间(2.8±1.4)d;肿瘤大小(18.5±4.5)mm;术后住院天数(7.0±2.5)d。肾上腺全切除组和部分切除组的肿瘤大小、术中失血量、住院时间和拔引流管时间差异无统计学意义(P>0.05)。全切除组手术时间短于部分切除组(P<0.05)。全切组术和部分切除组术后有效率分别为100%(34/34)和96.7%(58/60),两组间差异无统计学意义(P>0.05)。结论单发肾上腺醛固酮瘤适合于肾上腺部分切除术,肿瘤多灶性是保留肾上腺组织手术治疗无效的主要原因。对于部分切除术治疗无效患者,再次行患侧肾上腺全切除或肿瘤切除均可获得良好疗效。
Objective To compare the effect of retroperitoneal laparoscopic partial and total adrenalectomy for aldosterone-producing adenomas.Methods Data of 94 cases of aldosterone-producing adenomas were reviewed retorspectively.34 patients underwent total adrenalectomy,and 60 patients underwent partial adrennalectomy.All the patients were followed up for 6 months to 60 months,24.5 months in average.Results In the group of total adrenalectomy,mean operative time was 40.0 ±12.0 min;mean blood loss was（23.5±9.5） ml,mean drainage time was（2.5±1.2） d,mean tumour size was（20.0±5.0） mm and postoperative hospital stay was（6.5±2.0） d.In the group of partial adrenalectomy,mean operative time was（48.0±13.0） min,mean blood loss wsa（25.5 ±10.0） ml,mean drainage time was（2.8 ±1.4） d,mean tumour size was（18.5 ±4.5） mm and postoperative hospital stay was（7.0 ±2.5） d.There＇s no significant differencen in mean blood loss,mean drainage time,mean tumour size and postoperative hospital stay between total and partial group（P〈0.05）.Mean operative time of partial group was significantly longer than total group（P〈0.05）.The effective rate of total adrenalectomy was 100%（34/34） and 96.7%（58/60） in partial group,without significant difference（P〈0.05）.Conclusions Retroperitoneal laparoscopic partial adrenalectomy was a appropriate choice in aldosterone-producing adenomas if the lesion was single.The disease would relapse in case of multiple tumors.Total adrenalectomy or another partial adrenalectomy should be done when the first partial adrenalectomy was unsuccessful.
出处
《中华腔镜泌尿外科杂志（电子版）》
2013年第4期19-22,共4页
Chinese Journal of Endourology(Electronic Edition)
关键词
原发性醛固酮增多症
醛固酮瘤
肾上腺切除
Primary aldosteronism
Aldosterone-producing adenomas
Adrenalectomy
