后腹腔镜在肾上腺手术中的应用  

Application of retroperitoneal laparoscopy adrenalectomy

作　　者：李连鹏[1] 杨波[1] 马志芳[1] 赵永刚[1] 马为民[1] 张淑娟[1] 

机构地区：[1]山东省滨州市中心医院,251700

出　　处：《中国实用医刊》2012年第17期31-33,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨后腹腔镜下肾上腺肿瘤切除的方法和应用体会。方法采用后腹腔镜对68例患者行肾上腺占位性病变切除术。左侧30例，右侧38例。其中原发性醛固酮增多症28例，皮质醇增多症19例，嗜铬细胞瘤13例，无功能腺瘤5例，其余2例。瘤体直径0．8～7．0cm，平均2．8cm。结果完成腹膜后腹腔镜手术67例，1例因瘤体较大与下腔静脉粘连紧密中转开放手术。手术时间30～380min，平均100min。术中出血量20～350ml，平均46ml。住院时间3～14d，平均5．2d。所有患者均未输血。对完成手术的67例患者随访3～37个月，平均16个月，未发现肿瘤复发。结论后腹腔镜在肾上腺占位性病变切除术具微创、安全有效、出血少、术后恢复快和住院时间短等优势，是治疗肾上腺占位性病变的首选方法。Objective To investigate the value and clinical experience of retroperitoneal laparo- scopic adrenalectomy. Methods A total of 68 cases of retroperitoneal laparoscopy in adrenalectomy were performed in our study（left 30 cases and right 38 cases）. Among all the cases, Cushing＇ s syndrome was diagnosed in 28 patients,pheochromocytoma in 19 cases, nonfunctioning adenoma in 5 cases, and other diseases were found in 2 cases. The tumor＇ s diameter was from 0. 1 cm to 7.0 cm, means 2. 8 cm. Re- suits Sixty-seven cases of retroperitoneal laparoscopic adrenalectomy were completed successfully with a mean operation time of 100 minutes（30 -380 minutes）, and a median blood loss of 46 ml（20 -350 ml）. A media length of stay was 5.2 （3 - 14） days. No patient received red blood cells transfusion. Follow up was available for 3 -37 （16） months in 67 patients;None of them had long-term complications or recur- rent tumors. Conclusions Retroperitoneal laparoscopic adrenalectomy should be used as the first choice for benign adrenal neoplasms, since the procedure is safe, effective, and minimally invasive, and the pa- tients recovery quickly after the surgery.

关 键 词：腹腔镜 肾上腺切除术 

分 类 号：R73[医药卫生—肿瘤]