腹腔镜下治疗肾上腺嗜铬细胞瘤的疗效及安全性  

Effectiveness and Safety of Laparoscopy for Adrenal Pheochromocytoma

作　　者：王敏[1] 刘修恒[1] 陈志远[1] 陈晖[1] 

机构地区：[1]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《医学新知》2014年第6期373-374,377,共3页New Medicine

摘　　要：目的评价腹腔镜下治疗肾上腺嗜铬细胞瘤的疗效及安全性。方法采用腹腔镜下治疗肾上腺嗜铬细胞瘤31例。其中经后腹膜腔途径23例，经腹腔途径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例术中出现血压、心率剧烈波动，血压最高210／110mmHg，最低85／55mmHg，心率最高121bpm。其余患者手术过程中血压和心率平稳。术中出血量约为40—210ml，平均（70±21）ml，无一例患者输血，手术时间45—135min，平均（60±12）min。术后住院时间4～8d，平均5．1d10所有患者无明显并发症。术前内分泌检查VMA、N、NE增高者，术后3个月复查恢复正常。术后随访3—24个月，未见症状复发及肿瘤局部复发。结论腹腔镜下治疗肾上腺嗜铬细胞瘤具有较高的安全性；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腔入路或后腹膜腔入路。Objective To evaluate the effectiveness and safety of laparoscopy for adrenal pheochromocytoma. Methods 31 patients with adrenal pheochromocytoma were treated by laparoscopy, in which 23 from retroperitoneal and 8 from peritoneal. Results Operations were successful in all patients. All of them were diagnosed as pheochromocytoma pathologically. Conspicuous fluctuation of blood pressure （maximum blood pressure was 210/110 mmHg and minimum blood pressure was 85/55 mmHg）and heart rate（ maximum heart rate was 121 bpm）were observed in 4 cases. Stationary blood pressure and heart rate were observed in the others. The amount of bleeding was 40 ~ 210 mt with average of （70 ± 21 ）ml. Blood transfusion was not needed in any patient. The average operative time was （60 ± 12） min（range from 5 to 135 min）. The average hospital stay was 5.1 days（range from 4 to 8 days）. No significant complications were observed. VblA, N and NE recovered to normal 3 months after operation. No symptom relapse and local relapse reoccurred. Conclusion It is safe to treat adrenal pheochromocytoma by laparoscopy. It is extremely important for preoperative preparation. We can choose laparoscopic or retroperitoneal laparoscopic surgery according to 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]