机器人辅助腹腔镜下儿童肾上腺肿瘤切除术的初步探讨  

Preliminary experience of robotic adrenalectomy for children with adrenal tumor

作　　者：陈艳[1] 杨刚刚[1] 黄轶晨[1] 吕逸清[1] 李晓溪[1] 李惠珍[2] 许传亮[2] 孙颖浩[2] 陈方[1] 谢华[1] Chen Yan;Yang Ganggang;Huang Yichen;Lyu Yiqing;Li Xiaoxi;Li Huizhen;Xu Chuanliang;Sun Yinghao;Chen Fang;Xie Hua(Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China;Department of Urology, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200433, China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院泌尿外科,200062 [2]第二军医大学附属长海医院泌尿外科,200433

出　　处：《中华小儿外科杂志》2019年第2期137-142,共6页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨机器人辅助腹腔镜下儿童肾上腺肿瘤切除术的疗效及安全性。方法回顾性分析2013年10月至2017年1月我院收治的5例机器人辅助腹腔镜下肾上腺肿瘤切除术患儿的临床资料。5例患儿,男3例,女2例,年龄5岁2个月至10岁,平均7岁5个月。左侧2例,右侧3例。临床表现腹痛2例,阴蒂肥大1例,常规体检行B型超声检查发现肾上腺占位2例。内分泌检查提示1例为功能性肿瘤,4例为无功能性肿瘤。所有患儿术前均行增强CT或增强MRI检查证实为肾上腺占位。所有肿块边界清楚,未发现下腔静脉、肾静脉、肾蒂淋巴结受累和远处转移病变。5例均在机器人辅助腹腔镜下经腹腔途径顺利完成肾上腺肿瘤切除术,术中无中转开放。平均腹腔内手术操作时间(不含装机及取标本、关腹时间)153min(91~206min),估计平均出血量33ml(5~50ml)。肿瘤平均最大直径4.8cm(4~7cm)。术后病理提示分别为节细胞神经瘤4例、嗜酸细胞腺瘤1例。结果所有患儿术后恢复良好,平均术后6d出院(4~7d)。出院后平均随访30个月(14~53个月),无肿瘤复发。结论机器人辅助腹腔镜下肾上腺肿瘤切除术可以安全、有效地应用于选择性儿童肾上腺肿瘤的治疗。Objective To evaluate the outcomes and safety of robotic-assisted laparoscopic adrenalectomy for children with adrenal tumor. Methods A retrospective study was performed in five patients undergoing robotic-assisted laparoscopic adrenalectomy from October 2013 to January 2017. Results There were 3 boys and 2 girls with an average age of 7 (5-10) years.The involved side was left (n=2) and right (n=3). There were abdominal pain (n=2), clitoral hypertrophy (n=1) and ultrasonic detection (n=2). All procedures were successfully performed without any conversion into open surgery.The average operative duration was 153 (91-206) min, the mean estimated volume of blood loss 33 (5-50) ml and the mean tumor diameter 4.8(4-7) cm.Histopathological examination hinted at ganglioneuromas (n=4) and oncocytoma (n=1). All of them recovered well postoperatively.The mean hospital stay was 6 (4-7) days.During a mean follow-up period of 30 (14-53) months, there was no onset of recurrence or metastasis. Conclusions Robotic-assisted laparoscopic adrenalectomy may be safely and effectively performed for pediatric adrenal tumor.

关 键 词：儿童 机器人 腹腔镜 肾上腺肿瘤 

分 类 号：R736.6[医药卫生—肿瘤]