后腹腔镜巨大肾上腺肿瘤切除12例临床分析  

Clinical Analysis of Retroperitoneal Laparoscopy for Excision of 12 Cases of Large Adrenal Tumor

作　　者：李伟[1,2] 肖民辉[1] 余闫宏[1] 杨小华[1] 杨桦[1] 邹岷[1] 太荣芬[1] 叶章群[3] 

机构地区：[1]云南省第一人民医院泌尿外科,昆明650032 [2]华中科技大学同济医学院 [3]华中科技大学同济医学院附属同济医院泌尿外科

出　　处：《临床泌尿外科杂志》2010年第10期746-747,749,共3页Journal of Clinical Urology

摘　　要：目的:探讨后腹腔镜手术治疗巨大肾上腺肿瘤的体会。根据肿瘤大小、性质、血供情况、毗邻关系等,针对性制定个性化切除方案,确保手术安全、高效。方法:2002年3月～2010年2月,使用腹腔镜治疗10～1 9cm肾上腺肿瘤12例,男7例,女5例,左侧8例,右侧4例。年龄28～65岁,平均39岁。其中嗜铬细胞瘤2例,肾上腺皮质腺瘤4例,肾上腺髓样脂肪瘤5例,肾上腺转移性肿瘤1例。结果:本组1 2例,手术时间110～1 70min,平均130 min。术中出血60 ml～300 ml,平均(120±20)ml,4例输血300～800 ml。术后住院时间6～10天,无严重并发症发生。结论:后腹腔镜是治疗肾上腺肿瘤的金标准,巨大肾上腺肿瘤的切除难度较大。术前充分准备,制定个性化的围手术期治疗方案,把握操作技巧,缩短手术时间是确保手术顺利实施及患者安全的要素。Objective：To evaluate retroperitoneal laparoscopic adrenalectomy for large adrenal tumors, and formulate characterized therapeutic regimen to ensure safety and high performance according to the size, property, blood supply and adjacent relations of the tumors. Methods：From March 2002 to February 2010, 7 male and 5 female patients of large adrenal tumors over 10 cm were treated with retroperitoneal laparoscopy in our hospital, and 8 cases were left and 4 were right. The mean years was 39 （range 28 65）. The tumor diameter was from 10 to 19 cm. 2 cases of adrenal pheochromacytoma, 4 cases of adrenal cortical ademoma, 4 cases of medullary liparompha- lus, and 10 cases of metastatic lumor. Results： The procedures were successful in the 12 cases and the duration was 110 170 minutes with a mean of 130 minutes. The hlood loss ranged from 60 to 300 ml and mean 120 ml. 4 cases received blood transfusion. This group was hospitalized from 6 to 10 days. No complications occurred during operation and postoperatively. Conclusions：Retroperitoneal laparoscopic adrenalectomy is a gold standard for large adrenal tumor with microinvasiveness, less bleeding, rapid postoperative recovery, and fewer complications. Sufficient preoperative preparation, characterized perioperative treatment, sophisticated operative technique and short operative time should be considered as the absolutely necessary principles in treating large adrenal tumors.

关 键 词：腹腔镜 肾上腺肿瘤 手术 

分 类 号：R736.6[医药卫生—肿瘤]