改良肿瘤基底包囊内剜出术治疗巨大肾上腺肿瘤  

Treatment of the enormous adrenal mass by modified enucleation

作　　者：叶章群[1] 蔡建良[1] 杨为民[1] 陈志强[1] 张旭[1] 刘继红[1] 杜广辉[1] 胡志全[1] 周四维[1] 李家贵[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030

出　　处：《中华泌尿外科杂志》2005年第1期36-37,共2页Chinese Journal of Urology

摘　　要：目的　探讨侵及周围脏器和大血管的巨大肾上腺肿瘤的手术切除技巧和方法。　方法　采用肿瘤基底包囊间断缝合、肿瘤楔形切除、残留包囊对端缝扎止血法对 15例巨大肾上腺肿瘤患者施行改良肿瘤基底包囊内剜出术。患者肿瘤分别侵及胰尾、左肾、脾脏、主动脉或下腔静脉。　结果　手术时间 12 0～ 2 5 0min ,平均 181min ;术中出血 15 0～ 2 0 0 0ml,平均 916ml;15例肿瘤组织均经囊内剜除干净 ,仅留基底包囊 ;无一例周围脏器和大血管损伤 ,无一例死亡 ;患者术后恢复良好 ,术后 10～ 16d出院。　结论　对侵及周围脏器和大血管的巨大肾上腺肿瘤采用改良肿瘤基底包囊内剜出术安全、有效 ,值得临床上推广应用。Objective To investigate the operative method and technique for resection of the enormous adrenal mass invading the peripheral organs and large vessels. Methods The wedging enucleation of neoplasmas was performed in 15 patients with enormous adrenal masses after interrupted suture under the basis of the mass capsule,and then the sutures on remnant capsule were ligated by face to face way for hemostasis. Results The mean operation time was 181 min with a range from 120 to 250 min.The mean bleeding volume was 916 ml with a range from 150 to 2000 ml.All the tumor tissues were completely enucleated and only basal capsule was retained.No patient was complicated with the injury of the peripheral organs and large vessels,and the mortality rate was zero.All patients had favorable postoperative recovery and the time from the postoperation day to discharge was 10 to 16 days. Conclusions For enormous adrenal mass that has invaded the peripheral organs and large vessels,modified enucleation of the neoplasms is a safe and effective therapeutic means which can be generally used in clinical practice.

关 键 词：肾上腺肿瘤 治疗学 外科手术 包囊内剜出术 

分 类 号：R736.6[医药卫生—肿瘤]