机器人辅助腹腔镜下嗜铬细胞瘤切除术21例报告  

Robot-assisted laparoscopic resection of pheochromocytoma(Report of 21 cases)

作　　者：孔德波[1] 王平[1] 秦杰[1] 叶孙益[1] 景泰乐[1] 来翀[1] 孟宏舟[1] 夏丹[1] 汪朔[1] 

机构地区：[1]浙江大学附属第一医院泌尿外科,杭州310003

出　　处：《临床泌尿外科杂志》2016年第1期26-28,共3页Journal of Clinical Urology

摘　　要：目的：总结机器人辅助腹腔镜下嗜铬细胞瘤切除术的手术经验,探讨该术式的可行性及安全性。方法：2014年10月-2015年10月实施机器人辅助腹腔镜下嗜铬细胞瘤切除术21例,其中男11例,女10例。年龄22-72岁,平均52.2岁。肿瘤位于左肾上腺11例,右肾上腺7例,主动脉旁2例,右侧髂血管区1例。肿瘤最大径2.7-10.0cm,平均5.3cm。所有患者均完成术前定性定位检查,14例（66.7%）患者术前血儿茶酚胺升高。术前给予α阻滞剂治疗和扩容准备,记录手术方式、手术时间、出血量、住院时间等数据。结果：所有患者手术均在机器人辅助下完成,无中转开放手术者,无中转手助者。其中经腹径路手术18例,经腹膜后径路手术3例。手术时间1.50-3.38h,平均2.24h,中位手术时间2.18h。出血量10-1000ml,平均141.4ml,中位出血量50ml。85.7%（18/21）的患者术中出现血压波动。住院时间7-22d,平均11.9d。术后1个月复查,所有术前儿茶酚胺升高的患者术后儿茶酚胺均恢复正常。结论：机器人辅助腹腔镜下嗜铬细胞瘤切除术是一种安全有效的治疗嗜铬细胞瘤的手术方式,可以按不同的肿瘤部位和大小选择经腹径路或经腹膜后径路。Objective：To summarize the experience of robot-assisted laparoscopic resection of pheochromocytoma and discuss the feasibility and safety of this technique.Method：Twenty-one cases of robot-assisted laparoscopic resection of pheochromocytoma were performed from October 2014 to October 2015,which included eleven males and ten females.The average patients＇ age was 52.2（range,22-72）years old.Eleven tumors located in the left adrenal gland,seven tumors located in the right adrenal gland,two tumors located in the paraaortic region and the rest one tumor located in the right iliac vessel region.The maximum diameter of the tumor was 2.7-10（average,5.3）cm.All patients underwent preoperative qualitative and localization examination.Fourteen（66.7%）of them were found elevated serum catecholamine.Preoperative preparation was performed throughα-blocker therapy and expansion of blood volume.The operation mode,operation time,blood loss and hospital stay were recorded.Result：All the operations were performed under the assistance of the robot,and there was no conversion to open surgery or to the hand-assisted.Abdominal approach were performed in 18 cases,and retroperitoneal approach were performed in three cases.The operation time ranged from 1.50 to 3.38 hours,with an average of 2.24 hours and median time of 2.18 hours.The amount of blood loss was 10 to 1 000 ml,with an average of 141.4ml,and median blood loss of 50 ml.Blood pressure fluctuation was found in 85.7%（18/21）patients.Hospital stay was 7to22 days,with an average of 11.9days.All of the patients with catecholamine elevation recovered to normal range a month after surgery.Conclusion：Robot-assisted laparoscopic resection of pheochromocytoma is a safe and effective surgical method,and the decision of abdomen or retroperitoneal approach rely on different tumor location and size.

关 键 词：嗜铬细胞瘤 机器人手术 肾上腺肿瘤 副神经节瘤 

分 类 号：R736.6[医药卫生—肿瘤]