后腹腔镜肾上腺囊肿去顶术与切除术临床疗效分析  

Retroperitoneal laparoscopic decortication and adrenalectomy for the therapy of adrenal cysts

作　　者：任建[1] 王翔[1] 刘乃波[1] 张冠[1] 于力[1] 

机构地区：[1]卫生部中日友好医院泌尿外科,北京100029

出　　处：《中华医学杂志》2013年第26期2059-2061,共3页National Medical Journal of China

摘　　要：目的总结肾上腺囊肿临床特点，比较两种不同的后腹腔镜手术方式的治疗效果。方法回顾分析2005年5月至2012年6月北京中日友好医院收治的16例肾上腺囊肿患者的临床和病理资料。男7例，女9例，平均年龄39．4岁，伴有临床症状者8例，其余为体检发现。16例患者均手术治疗，后腹腔镜肾上腺囊肿切除术11例，后腹腔镜肾上腺囊肿去顶术5例。结果术后病理证实为肾上腺囊肿，占同期肾上腺外科疾病的7．5％。术前CT的诊断准确比例为11／16，MRI为3／3。囊肿平均直径5．3em（1—14cm）。术后平均随访48个月，症状的缓解比例为7／8，未见复发。后腹腔镜肾上腺囊肿去顶术在手术时间（48±10）min和术中出血量（16±11）ml两方面显著少于后腹腔镜肾上腺囊肿切除术[（74±21）min和（34±30）ml]。结论腹腔镜是治疗肾上腺囊肿的有效方式，对于较大的良性囊肿，可考虑选择后腹腔镜肾上腺囊肿去顶术。Objective To summarize the clinical characteristics of adrenal cysts and compare the therapeutic results of two different laparoscopie surgical techniques. Methods Sixteen patients of adrenal cysts were summarized retrospectively from May 2005 to June 2012. Their clinical manifestations, pathological features, therapeutic effects and prognosis were analyzed. There were 7 males and 9 females aged 39.4（25 -68 ） years. Eight patients were symptomatic and the others were identified incidentally. They underwent laparoscopic surgery through retroperitoneal space, including adrenaleetomy （n = 11）and decortication （n =5）. Results All were confirmed as adrenal cysts by postoperative pathological examination. It accounted for around 7.5% of adrenal disease treated surgically at our department eoetaneous. The diagnostic accuracy of computed tomography and magnetic resonance imaging was 11/16 and 3/3 respectively. The mean diameter of cyst was 5.3 （ 1 - 14） cm and no apparent endocrine abnormalities were found. The symptoms of 7/8 patients were relieved after a mean 48 months follow-up. No recurrence was found in this cohort. The average operative duration and estimated volume of blood loss were significantly less in laparoscopic decortication group （ （48 ± 10） min, （ 16 ± 11 ） ml）than laparoscopic adrenaleetomy group （（74 ± 21 ） min, （34 ± 30 ） ml）. Conclusions Laparoscopic surgery is an effective procedure for the treatment of adrenal cysts. And retroperitoneal laparoseopic decortieation may be preferred treatment option for large benign adrenal cysts.

关 键 词：肾上腺疾病 囊肿 泌尿外科手术 腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]