腹膜后腹腔镜治疗肾上腺疾病28例报告  

Retroperitoneal laparoscopy for the treatment of adrenal diseases:with a report of 28cases

作　　者：张爱民[1] 成波[1] 

机构地区：[1]山东省胜利油田中心医院,山东东营257034

出　　处：《腹腔镜外科杂志》2009年第8期588-590,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹膜后腹腔镜手术切除肾上腺病变的临床效果。方法：回顾分析我院为28例肾上腺病变患者行腹膜后腹腔镜肾上腺切除术的临床资料,其中皮质醇腺瘤4例,醛固酮腺瘤11例,嗜铬细胞瘤3例,无功能腺瘤8例,肾上腺囊肿2例。用观察镜扩张后腹腔,3个Trocar经腰部穿刺,超声刀切除肿瘤,用自制标本袋取出肿瘤。结果：28例手术均获成功,手术时间45～120min,平均70min。术中出血20～300ml,平均60ml,患者均未输血。切除肿瘤直径1～4.5cm,平均3.2cm。随访28例6～48个月,平均13个月,未见肿瘤复发和转移,肾上腺内分泌检查均恢复正常。结论：腹膜后腹腔镜肾上腺肿瘤切除术具有微创、患者出血少、康复快、并发症少等优点,可作为治疗肾上腺良性疾病的首选方法。Objective：To evaluate the clinical effect of retroperitoneal laparoscopic adrenalectomy.Methods：Twenty-eight patients with adrenal diseases were treated by retroperitoneal laparoscopic adrenalectomy.There were 18 cases of functional gland tumors,including 4 cases of Cushing s syndrome,11 cases of aldosterone-producing adenoma and 3 cases of adrenal pheochromocytoma.There were 8 cases of adrenal non-functional tumors and 2 cases of adrenal cyst.The laparoscope was used to dilate the retroperitoneal space and the operation was performed through 3 translumbar Trocars. The tumor was removed by a harmonic scalpel, and taken out of abdomen in a self-made specimen bag. Results：Operations were successful in all cases,operation time was 45-120min （mean,70min） and intraoperative blood loss was 20-300ml （mean, 60ml ）. There was no need of blood transfusion. The diameter of tumor was 1-4.5cm （mean,3.2cm）. Follow-up time ranged from 6 to 48 months（ mean, 13 months）. No tumor recurrence or metastasis was found in 28 cases. The adrenal endocrine markers were all nomal. Conclusions： Retroperitoneal laparoscopic adrenalectomy has advantages of minimal invasion, little blood loss, quick post-operative recovery, and low complication incidence. It should be considered as the first choice for treating benign adrenal diseases.

关 键 词：肾上腺疾病 肾上腺切除术 腹腔镜术 

分 类 号：R699.3[医药卫生—泌尿科学]