摘要
目的 评价腹腔镜和后腹腔镜肾上腺手术与开放肾上腺手术的临床价值。 方法 对 5 0例腹腔镜、后腹腔镜肾上腺手术和 4 3例开放肾上腺手术的临床资料进行比较 ,统计分析三种术式在手术时间、术后住院天数、术中平均出血量、术后并发症发生率等的差别。 结果 经后腹腔镜肾上腺手术 34例全部成功 ;腹腔镜手术 16例除 1例因腹腔广泛粘连改开放手术外 ,余 15例成功 ;4 3例开放手术均获成功。三组手术时间分别为 (6 4 .4± 2 9.2 )min ,(10 4 .3± 33.2 )min和 (12 1.7± 4 0 .2 )min。术后住院天数分别为 (5 .1± 1.6 )d、(5 .3± 1.4 )d和 (9.1± 1.8)d ;术中出血量分别为 (45 .6±36 .3)ml、(6 7.3± 4 2 .6 )ml和 (2 95 .8± 2 80 .8)ml。组间比较差别均有显著性意义 (P <0 .0 0 1)。腹腔镜组和后腹腔镜组术中无并发症 ;开放手术组术中发生胸膜损伤 7例 ,术中大出血 1例 (出血量 >10 0 0ml) ,术后 6例因感染或脂肪液化伤口愈合不佳。 结论 腹腔镜肾上腺手术在手术时间、术中出血量和术后恢复等方面明显优于开放手术 ,其中后腹腔入路虽技术难度较大 。
Objective To evaluate and compare laparoscopic and posterior laparoscopic adrenalectomy with open adrenalectomy. Methods The clinical data of 50 cases receiving laparoscopic and posterior laparoscopic adrenalectomy were compared with 43 cases receiving open adrenalectomy. The differences in operation time, hospitalization stay after operation, average bleeding volume during operation and occurrence of postoperative complication of the three procedures were compared. Results The posterior laparoscopic adrenalectomy were all successful. One case of those receiving laparoscopic adrenalectomy was changed to open operation due to extensive abdominal adhesion while the remaining ones were all successful. All the open adrenalectomy were successful. The operating time was (64.4±29.2) min, (104.3±33.2)min and (121.7±40.2) min for posterior laparoscopic, laparoscopic and open adrenalectomy respectively. The postoperation hospitalization was (5.1±1.6)days, (5.3±1.4)days and (9.1±1.8) days respectively, and the average bleeding volume during operation being (45.6±36.3)ml,(67.3±42.6)ml and (295.8±280.8) ml respectively.The difference in the three groups was significant ( P <0.001). No complication occurred in the laparoscopic and posterior laparoscopic adrenalectomy groups.In the open adrenalectomy group,pleural injury occurred in 7 cases, bleeding during operation (>1 000 ml)in one and the wound indolence in 6 because of infection or fat liquefaction. Conclusions The operation time, bleeding volume and postoperative recovery in laparoscopic adrenalectomy were superior to those in the open operation. Although the technical difficulty in posterior abdominal approach was greater, the operating efficacy was better than that via the abdominal approach.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2002年第6期332-334,共3页
Chinese Journal of Urology
