腹腔镜下肾上腺良性肿瘤切除术中经腹腔与经腹膜后途径的疗效比较  

Effect analysis of laparoscopic adrenalectomy via transperitoneal or retroperitoneal approaches

作　　者：李黔 张晨辉 王建华 秦荣良[2] 

机构地区：[1]陕西省铜川市人民医院泌尿外科,陕西铜川727000 [2]第四军医大学西京医院泌尿外科,陕西西安710032

出　　处：《中国内镜杂志》2012年第4期366-368,共3页China Journal of Endoscopy

摘　　要：目的比较与评价腹腔镜下经腹腔与经腹膜后途径在治疗肾上腺肿瘤中的临床价值。方法回顾性分析64例接受腹腔镜下经腹腔与经经腹膜后途径治疗的肾上腺肿瘤患者的临床资料,统计分析这两种术式在手术时间,术中出血量,术后肠功能恢复时间,术后住院时间及并发症发生率等方面的差异。结果 30例腹腔镜下经腹腔手术患者均获得成功。34例腹腔镜下经经腹膜后途径手术,除1例因病变周围粘连严重,1例因肾周脂肪层过厚中转开放手术,其余32例腹腔镜下经经腹膜后途径手术患者均获得成功。两组平均手术时间;平均手术出血量;术后肠功能恢复时间;术后住院时间等方面分别为(130±47)和(98±68)min,(79.1±61.0)和(58.3±61)mL,(2.9±0.7)和(1.9±0.6)d,(9.7±1.4)和(6.6±1.0)d。差异有显著性,P<0.05。结论腹腔镜下经腹膜后肾上腺肿瘤切除术手术时间,术后肠功能恢复时间及术后住院时间较短,手术出血量也低,值得临床应用。[Objective] To analyze and evaluate the clinical value of retroperitoneal and transperitoneal laparoscopic adrenalectomy for adrenal tumors.[Methods] Study the clinical information of 64 patients with adrenal tumors retrospectively carried out by laparoscopic adrenalectomy via transperitoneal（30 cases） and retroperitoneal（34 cases） approaches,and then analyze the statistical difference between these two operation approaches on operation time,blood loss,gastrointestinal function recovery time,hospital stay and rate of complications.[Results] Of the 34 cases of retroperitoneal adrenalectomy,conversions to open surgery were required in 2 cases because there＇s extensive abdominal adhesion in 1 case and another one had too thick perinephric fat.The rest cases were all done successfully as planned.And the average result of operation time,blood loss,gastrointestinal function recovery time,hospital stay and rate of complications for the cases carried out by laparoscopic adrenalectomy via transperitoneal and retroperitoneal approaches were described below respectively：（130±47）min and（98±68）min,（79.1±61）mL and（58.3±61）mL,（2.9±0.7）d and（1.9±0.6）d,（9.7±1.4）d and（6.6±1.0）d.[Conclusions] Laparoscopic adrenalectomy via retroperitoneal approach can be used as the better choice for the patients with adrenal tumors because it has more advantages of reliable effects than the transperitoneal approach method on operation time,blood loss,gastrointestinal function recovery time,hospital stay and rate of complications.

关 键 词：肾上腺肿瘤 腹腔镜 经腹腔 经腹膜后 肾上腺切除术 

分 类 号：R656.5[医药卫生—外科学]