经腹腔镜肾上腺肿瘤切除术两种手术路径比较  

Laparoscopic adrenalectomy for adrenal tumors by transperitoneal or retroperitoneal approaches：a report of 41 cases

作　　者：张增强[1] 黄海[2] 王卫峰[1] 

机构地区：[1]东莞市人民医院泌尿外科,广东省东莞523000 [2]广州中山大学附属第二医院泌尿外科

出　　处：《中国基层医药》2008年第10期1656-1657,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨两种手术入路施行腹腔镜肾上腺肿瘤切除术的手术效果及优缺点。方法41例肾上腺肿瘤患者分两组，经腹腔入路施行腹腔镜肾上腺肿瘤切除术16例，经腹膜后入路25例，对手术时间、术中出血量、术后平均住院日及术后平均下床时间和进食时间、术后并发症等各指标进行比较。结果41例中有3例中转开放手术，余38例腹腔镜手术均获成功。两组手术在肿瘤大小、术中出血量、术后平均住院日及术后平均下床时间上差异无统计学意义（均P〉0．05），但在平均手术时间上[（124．0±42．4）min、（95．7±32．6）min]差异有统计学意义（P〈0．05）。结论两种不同的入路施行腹腔镜肾上腺肿瘤切除术都是安全可行的，经腹膜后入路平均手术时间较短，但应根据病变性质、肿瘤大小、位置及患者具体情况选择手术入路。Objective To evaluate the effect of laparoscopic adrenalectomy for adrenal tumors by transperitoneal or retroperitoneal approaches. Methods Atotal of 41 laparoscopic adrenalectomy for adrenal tumor patients were pertormed,including 16 patients by transperitoneal approach and 25 patients by retroperitoneal approach. The tumor size, operative time,intraoperative blood loss, postoperative hospital stay, postoperative ambulatory day and postoperative complications were observed. Results Of the 41 cases,3 cases were transferred to open surgery and the other 38 cases were achieved successful operations. No significant differences （ all P 〉 0.05） were found in tumor size,intraoperative blood loss, postoperative hospital stay,postoperative ambulatory day between the transperitoneal group and retroperitoneal group, but there were significant differences （P 〈 0.05） in operative time and intraoperative blood loss between the two group. Conclusion Both the transperitoneal and retroperitoneal laparoscopic approaches are feasible and safe for adrenal tumors, and the latter has more advantages in operative time, but the operative approach still should be chosen based on the pathological changes, tumor size and position as well as the individual conditions of the patients.

关 键 词：肾上腺肿瘤 腹腔镜检查 临床分析 治疗方法 

分 类 号：R73[医药卫生—肿瘤]