腹腔镜与开放手术治疗嗜铬细胞瘤的安全性和疗效分析  

Comparsion between laparoscopic and open resection in pheochromocytoma : a review of 58 cases

作　　者：付阳[1] 张古田[1] 熊轶[1] 王彦刚[2] 纪长威[1] 赵晓智[1] 徐林峰[1] 李笑弓[1] 甘卫东[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008 [2]阜阳市第五人民医院泌尿外科,安徽236000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第2期6-9,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：江苏省人事厅六大人才高峰资助项目(2011-WS-007)

摘　　要：目的探讨腹腔镜手术与开放手术治疗嗜铬细胞瘤的安全性和疗效。方法回顾性分析南京鼓楼医院2010年10月至2014年3月间住院确诊为嗜铬细胞瘤的58例患者临床资料,左侧肾上腺嗜铬细胞瘤22例,右侧26例,双侧2例,异位嗜铬细胞瘤8例。按手术方式分为腹腔镜组和开放组,比较两组术中、术后及预后相关指标。结果两组58例手术均获得成功,术后病理均确诊为嗜铬细胞瘤。腹腔镜组和开放组的手术时间分别是（162±56）min和（213±44）min（t=3.30,P=0.001）;术中出血量分别是（158±402）ml和（1081±825）ml（z=-3.44,P=0.000）;术后住院时间分别是（9±2）d和（12±2）d（t=4.14,P=0.000）;肿瘤估算体积分别是（34±53）cm^3和（197±397）cm^3（z=-3.46,P=0.000）;腹腔镜组（41例）的术中输血、术中高血压、术后并发症的例数分别是7例、18例、1例,开放组（17例）则分别为12例、8例、4例,除术中高血压差异不明显外,两组的术中输血、术后并发症的例数均差异显著。两组58例均获随访,随访时间为5-42个月,两组疗效满意,均未出现肿瘤复发和转移。结论腹腔镜手术治疗嗜铬细胞瘤安全、有效;同样适用于异位嗜铬细胞瘤的手术治疗。We conducted a retrospective cohort study to determine whether laparoscopic resection of pheochromocytoma is a safe and effective therapy for the management of pheochromocytoma, eompared with open resection. Methods We collected pertinent data on 58 patients underwent pheochromocytoma resections. Perioperative outcomes of 41 laparoscopic resections of pheochromocytoma were compared with 17 open resections.Results Time of postoperative stay was shorter in the laparoscopic group [（9±2） d vs （12＋2） d, P〈0.05）], and turnout size was smaller [（34±53） cm^3 vs （197±397） cm^3, P〈0.05）]. The operation time was also shorter in laparoscopic group [（162±56） min vs （213±44） rain, P〈0.05）], the blood loss was less [（158±402） ml vs （1081 ±825） ml, P〈0.05）]. There were no statistically significant differences in intraoperative hypertensive episodes, the need for antihypertensive and vasopressin agents between the two group. The number of blood transfusion and postoperative complications in laparoscopic group were 7 case and 1 case while there were 12 case and 4 case in open group. During the follow-up of 5 to 47 months, there were no rumor recurrences or metastasis. There were no perioperative mortalities in this series. Conclusion The laparoscopic removal of pheochromocytoma is safe and effective. And also can be used for ectopic pheochromocytoma.

关 键 词：嗜铬细胞瘤 腹腔镜 安全性 疗效 

分 类 号：R736.6[医药卫生—肿瘤]