腹腔镜手术治疗儿童肾上腺区巨大肿瘤  

Laparoscopic surgery for large adrenal tumor in children

作　　者：钟海军[1] 毕允力[1] 陆良生[1] 刘颖[1] 汤梁峰[1] 

机构地区：[1]复旦大学附属儿科医院泌尿外科

出　　处：《临床外科杂志》2015年第11期813-815,共3页Journal of Clinical Surgery

基　　金：公益性行业科研专项资助项目(2014136)

摘　　要：目的：探讨腹腔镜手术治疗儿童肾上腺区巨大肿瘤（直径≥5 cm）的可行性和安全性。方法采用腹腔镜手术治疗的肾上腺区巨大肿瘤患儿5例，其中男3例，女2例；年龄3岁3个月~7岁5个月，平均年龄5.50岁；肾上腺肿瘤均位于右侧，肾上腺病灶最大直径均≥5 cm。结果5例患儿顺利完成腹腔镜手术。手术时间120~210分钟，平均144分钟；术中出血量15~30 ml，平均23 ml；术后住院时间4~10天，平均6天；出现并发症1例，为术中隔肌破裂、右侧肺水肿；术后病理检查证实为神经母细胞瘤1例，节细胞性神经母细胞瘤1例，节细胞神经瘤3例；5例均获随访6~36个月，均未发现肿瘤复发或转移。结论经腹腔镜手术治疗儿童肾上腺区巨大肿瘤切实可行、安全有效，但术前需要依据检查结果选择适当的病例，并由腹腔镜经验丰富、技术娴熟的术者进行。Objective To investigate the feasibility and safety of laparoscopic surgery for pediat-ric adrenal tumor larger than 5 cm. Methods The clinical data of five pediatric cases of laparoscopic sur-gery for large adrenal tumor were reviewed,including two girls and three boys,with an average age of 5. 50 （3. 25 ~ 7. 42）years. All tumors were located at the right side. The maximum diameter of adrenal lesion was larger than 5 cm. Results All the laparoscopic surgeries were successfully performed. The average operative time was 144（120 ~ 210）min,average blood loss 23. 00（15 ~ 30）ml,and average postoperative hospital stay 6（4 ~ 10）d. One case had intraoperative diaphragmatic rupture and right-side pulmonary e-dema. Pathological report revealed one neuroblastoma,three ganglioneuromas and one ganglioneuroblasto-ma. There were no recurrence or metastasis during the follow-up period（6 ~ 36 months）. Conclusion For children with large adrenal tumor,laparoscopic surgery is safe,effective,and practicable. According to preoperative examination,appropriate cases should be chosen by skilled surgeons with sufficient experi-ence.

关 键 词：儿童 腹腔镜 手术治疗 肾上腺肿瘤 

分 类 号：R736.6[医药卫生—肿瘤]