腹腔镜治疗肾上腺嗜铬细胞瘤的疗效及安全性  

Effect and Safety Evaluation of Laparoscopic Surgery for Adrenal Pheochromocytoma

作　　者：江波涛[1,2] 刘修恒[3] 孔东波[1,2] 邹伟[1,2] 陈晖[3] 匡幼林[3] 

机构地区：[1]湖北省咸宁市中心医院 [2]湖北科技学院附属第一医院泌尿外科,湖北咸宁437100 [3]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2012年第6期879-881,共3页Medical Journal of Wuhan University

摘　　要：目的:评价腹腔镜治疗肾上腺嗜铬细胞瘤的疗效及安全性。方法:采用腹腔镜治疗肾上腺嗜铬细胞瘤31例。其中经后腹膜途径23例,经腹膜途径8例。结果:所有患者手术均获成功。术后病理诊断皆为嗜铬细胞瘤。有4例出现血压、心率剧烈波动,血压最高达210/110 mmHg,最低达到85/55 mmHg,心率最高达121次/min。其余患者手术过程中血压和心率平稳。术中出血量约为40-210 ml,平均(70±21)ml,无1例患者输血,手术时间50-135 min,平均(60±20)min。术后住院时间4-8 d,平均5.1 d。所有患者无明显并发症,无切口感染。术前内分泌检查尿香草苦杏仁酸(VMA)、肾上腺素(N)、去甲肾上腺素(NE)增高者,术后3个月复查已经恢复正常。术后随访3-24个月,未见症状复发以及肿瘤局部复发。结论:腹腔镜治疗肾上腺嗜铬细胞瘤具有相当高的安全性,充分的术前准备是手术成功的关键,术者可根据经验和肿瘤大小选择经腹入路腹腔镜手术或腹膜后入路腹腔镜手术。Objective： To evaluate the effect and safety of laparoscopic resection of adrenal pheochromocytoma.Methods： Thirty one patients with adrenal pheochromocytoma were treated by laparoscopic and retroperitoneal laparoscopic surgery.Results： The operations were successful in all the patients.No patient required conversion to open surgery.The operation time was 50-135 min with a mean of（60±20） min.Conspicuous fluctuation of blood pressure was observed in four patients during operation.The postoperative hospital stay was 4-8 days with a mean 5.1 days.Conclusion： It was effective and safe by laparoscopic adrenalectomy for pheochromocytoma.It was extremely important for preoperative preparation.Whether laparoscopic or retroperitoneal laparoscopic surgery is chosen according to the doctors＇ experience and the size of tumor.

关 键 词：嗜铬细胞瘤 腹腔镜手术 疗效 安全性 

分 类 号：R699.3[医药卫生—泌尿科学]