摘要
目的目标性后腹腔镜与常规后腹腔镜肾上腺切除术的临床效果。方法回顾性分析我院2015年7月~2022年12月手术治疗135例肾上腺良性肿瘤的临床资料,其中目标性后腹腔肾上腺切除术65例(目标组),常规后腹腔镜肾上腺切除术70例(常规组),比较2组手术时间、术中出血量、切口长度、术后引流量、术后引流时间、术后住院时间、术后疼痛语言等级评定量表(Verbal Rating Scale,VRS)。结果2组手术均顺利完成,无中转开放手术。目标组术中出血量[(29.4±16.6)ml vs.(40.1±17.4)ml,t=-3.653,P=0.000]、手术切口长度[(2.7±1.0)cm vs.(3.5±0.6)cm,t=-5.323,P=0.000]、术后引流量[(34.2±18.4)ml vs.(42.1±18.7)ml,t=-2.494,P=0.014]、术后疼痛VRS评分[(1.9±0.7)分vs.(2.2±0.7)分,t=-2.748,P=0.006]和术后住院时间[(4.5±0.9)d vs.(5.0±1.1)d,t=-3.257,P=0.001]显著优于常规组,手术时间明显长于常规组[(56.4±22.0)min vs.(48.1±15.4)min,t=2.509,P=0.012]。135例术后随访3~19个月,平均11个月,无复发和并发症。结论目标性后腹腔镜肾上腺切除术安全有效,术中出血量、术后疼痛评分,术后住院时间优于常规后腹腔镜肾上腺切除术,但手术时间较长,有待技术及器械的改进。
Objective To compare clinical outcomes of goal-oriented retroperitoneal laparoscopic versus conventional retroperitoneal laparoscopic adrenalectomy.Methods A retrospective analysis was made on clinical data of 135 patients with benign adrenal tumors treated surgically in our hospital from July 2015 to December 2022,including 65 cases of goal-oriented retroperitoneal laparoscopic adrenalectomy(goal-oriented group)and 70 cases of conventional retroperitoneal laparoscopic adrenalectomy(conventional group).All the surgeries were performed by the same operator.The clinical data such as operative time,intraoperative bleeding,incision length,postoperative drainage,postoperative drainage time,postoperative hospital stay,and postoperative pain verbal rating scale(VRS)were statistically analyzed in both groups.Results The surgery was completed in both groups without conversion to open surgery.In terms of intraoperative bleeding[(29.4±16.6)ml vs.(40.1±17.40)ml,t=-3.653,P=0.000],surgical incision length[(2.7±1.0)cm vs.(3.5±0.6)cm,t=-5.323,P=0.000],postoperative drainage[(34.2±18.4)ml vs.(42.1±18.7)ml,t=-2.494,P=0.014],postoperative pain VRS[(1.9±0.7)points vs.(2.2±0.7)points,t=-2.748,P=0.006]and postoperative hospital stay[(4.5±0.9)d vs.(5.0±1.1)d,t=-3.257,P=0.001],the goal-oriented group was superior to the conventional group,with differences being statistically significant.However,the operative time was longer in the goal-oriented group than that in the conventional group[(56.4±22.0)min vs.(48.1±15.4)min,t=2.509,P=0.012].Postoperative follow-ups ranged for 3-19 months with a mean of 11 months,with no recurrence or complications.Conclusions Goal-oriented retroperitoneal laparoscopic adrenalectomy is safe and effective,which is superior to the conventional surgery in terms of intraoperative bleeding,postoperative pain scores,and postoperative hospital stay.However,the operative time was longer,requiring improvement of techniques and instruments.
作者
谢程
支运来
孙方浒
耿申
吉振帅
张鹏程
蔡成宽
Xie Cheng;Zhi Yunlai;Sun Fanghu(Department of Urology,First People’s Hospital of Lianyungang,Affiliated Lianyungang Hospital of Xuzhou Medical University,Lianyungang 222061,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第8期571-575,共5页
Chinese Journal of Minimally Invasive Surgery
基金
连云港市国家创新型城市建设(社会发展)项目(SH1405)。
关键词
肾上腺切除术
后腹腔镜手术
Adrenalectomy
Retroperitoneal laparoscopic surgery
