机器人辅助腹腔镜术治疗压迫大血管的巨大嗜铬细胞瘤和副神经节瘤6例报告  

Robot-assisted laparoscopic resection of giant pheochromocytoma and paraganglioma with large vessel compression(Report of six cases)

作　　者：何威[1] 徐兆平[1] 祝宇[1] 张荣明[1] 钟山[1] 王先进[1] 王晓晶[1] 沈周俊[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《临床泌尿外科杂志》2014年第3期215-218,共4页Journal of Clinical Urology

摘　　要：目的：评价机器人辅助腹腔镜术治疗压迫大血管的嗜铬细胞瘤和副神经节瘤的可行性和安全性。方法：回顾性分析2012年5月～2013年10月间所行4例机器人辅助腹腔镜肾上腺嗜铬细胞瘤切除术和2例机器人辅助腹腔镜副神经节瘤切除术患者的临床资料：所有患者术前均通过内分泌检查和影像学检查定性定位。手术采取侧卧位经腹腔途径。通过记录患者的人口学数据、肿瘤大小、手术时间（operating time，OT）、失血量（estimated blood loss，EBL）、术中血压波动次数（intraoperative blood fluctuation，IBF）、住院天数（hospital stay，HS）及术后内分泌随访情况来分析手术效果。结果：所有手术均成功完成，中位肿瘤直径、OT、EBL、IBF和HS分别为73mm、102．5min、120ml、3次和4．5天。术后1个月随访时，所有患者术前升高的血变肾上腺素（meta—nephrine，MN）或血变去甲肾上腺素（normetanephrine，NMN）均恢复正常。结论：采用机器人辅助腹腔镜手术治疗压迫大血管的。肾上腺嗜铬细胞瘤或副神经节瘤是安全可行的。Objective： To evaluate the safety and feasibility of robot-assisted laparoscopic resection of giant pheochromocytoma and paraganglioma with large vessel compression. Method：The data of four cases of pheochromocytoma and two cases of paraganglioma from May. 2012 to Oct. 2013 were analyzed retrospectively. All patients were diagnosed by imaging study and endocrinology and the operations were performed by transperitoneal approach in lateral position. The demography, clinical manifestation of the patients, operating time （OT）, esti- mated blood loss （EBL）, intraoperative blood pressure fluctuation （IBF） and postoperative hospital stay （HS） were documented. Result：All operations were successfully performed. The median tumor diameter, OT, EBL, IBF and HS were 73 mm, 102.5 rain, 120 ml, 3 times and 4.5 days respectively. The level of metanephrine （MN） and normetanephrine （NMN） of all patients returned to normal range in the first follow-up period of one month. Con- clusion：The procedure of robot-assisted laparoscopic resection of giant pheochromocytoma and paraganglioma with large vessel compression is safe and feasible.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 副神经节瘤 机器人手术 

分 类 号：R736.6[医药卫生—肿瘤]