摘要
目的探讨后腹腔镜手术治疗肾上腺嗜酸细胞腺瘤的可行性和安全性。方法分析天津医科大学总医院泌尿外科自2009年至2013年收治的4例肾上腺皮质嗜酸细胞腺瘤患者的临床资料，并复习文献。4例患者术前进行完善的内分泌学检查及影像学检查。对CT显示包膜完整，边界清楚的3例患者行后腹腔镜手术治疗（2例行肾上腺全切术，1例行肾上腺部分切除术），对CT提示边界不清，包膜欠光滑的1例患者行开放。肾上腺全切术。结果4例患者手术均取得成功，行后腹腔镜手术的3例患者术中见肾上腺区类圆形肿物，包膜完整，和周围界限清楚，容易分离，无明显出血，术后病理回报肾上腺皮质嗜酸细胞腺瘤，行开放手术的1例患者术中见肾上腺区肿物，和肾脏上极有粘连，周围血管丰富，术后病理为肾上腺皮质嗜酸细胞腺瘤恶性倾向。随访6个月～4年，无复发和转移。结论肾上腺皮质嗜酸细胞腺瘤是一种少见的疾病，肿瘤体积一般较大，对于CT和MRI提示包膜完整、周围无浸润的肿瘤，后腹腔镜手术是安全可行的，。肾上腺部分切除术是一种可选择的手术方式。
Objective To investigate the feasibility and safety oflaparoscopic surgery for treatment of adrenal oncocytoma. Methods The clinical data of 4 cases with adrenocotical oncocytic neoplasms were retrospectively analyzed and discussed with literature reviewed. Endocrinalogical tests and imageological examination were performed preoperatively. 3 patients whose tumor capsules were integrated and not adherent to the adjacent tissue, underwent laparoscopic operation（2 cases underwent adrenal resection, 1 case underwent partial adrenal resection）. Another patient underwent open adrenal tumor resection because of unintegrated tumor capsule. Results Operations were compeleted successfully. The mass completely encapsulated and easyily dissected in 3 case by laparoscopy. No massive blood loss or hemodynamic instability events were encountered perioperatively, the pathological findings were adrenocortical oncocytic adenomas. One case underwent open adrenal excision, the mass was adherent to the upper pole of kidney and surrounded by a lot of vein. The pathological finding was adrenocortical oncocytic adenomas with malignant potential. No recurrence or metastasis was found after close follow-up observation for 6-48 months. Concltmion Adrenocortical oncocytoma are extremely rare. It is usually a large, benign, nonfimctional adrenal tumor. Laparoscopy for adrenocortical oncocytoma is safe and feasible. Adrenal partial nephrectomy is an alternative surgical approach.
出处
《中华腔镜泌尿外科杂志（电子版）》
2015年第5期45-48,共4页
Chinese Journal of Endourology(Electronic Edition)
