单切口经脐三角腹腔镜手术在右侧肾上腺肿瘤切除中的初步应用  

Resection of laparoscopic right adrenal tumor with single incision triangulated umbilicus surgery technique

作　　者：祝广峰[1] 窦小亮[1] 张志明[1] 高小平[1] 付强[1] 王禾[1] 汪涌[1] 

机构地区：[1]第四军医大学唐都医院泌尿外科,陕西西安710038

出　　处：《现代泌尿外科杂志》2017年第11期844-847,共4页Journal of Modern Urology

摘　　要：目的探讨单切口经脐三角腹腔镜手术(又名经脐可拉伸切口多通道腹腔镜手术,SITUS)在右侧肾上腺切除中的手术体会。方法 2015年8月至2017年4月,对15例右侧肾上腺肿瘤实施SITUS肾上腺切除术。结果 15例患者均顺利完成手术。手术时间平均(67.0±22.5)min,出血量平均(40.2±23.7)mL。15例患者术中、术后均未输血,术后拔除引流管时间平均为(2.5±0.8)d,术后住院时间平均(3.8±2.2)d,术中于右侧腋前线肋缘下增加1个5mm辅助通道,用以牵开肝脏,暴露术野。术后伤口隐藏于脐周,美容效果良好。结论 SITUS手术方式进行右侧肾上腺肿瘤切除手术可行,手术安全,术后瘢痕可隐藏于脐周围,临床开展不需要特殊器械,手术难度较普通腹腔镜有一定增加,但可克服。Objective To explore the techniques involved in the resection of right adrenal tumor with single-incision triangulated umbilical surgery(SITUS).Methods The clinical data of 15 patients undergone right adrenal gland tumor resection with laparoscopic SITUS during Aug.2015 and Apr.2017 in our department were retrospectively analyzed.Results All operations were performed successfully without conversion to open surgery or traditional laparoscopic surgery.The mean operative time was(67.0±22.5)min.The mean blood loss was(40.2±23.7)mL.No blood transfusion was required during or after the operations.The drainage tube was removed(2.5±0.8)days postoperatively,and the average hospital stay was(3.8±2.2)days.During the operation,a5 mm auxiliary access was established on the coastal margin of the right anterior auxiliary line,which was used to pull the liver and expose the surgical field.After the operation,the incision was concealed in theperipheral umbilicus and showed a good cosmetic result.Conclusion The laparoscopic SITUS is feasible and safe for right adrenal tumor resection.As the majorscars are hidden in the umbilicus,the cosmetic effect is satisfactory.Although slightly more difficult than common laparoscopic operations,SITUS can be performed without special instruments.

关 键 词：单切口经脐三角腹腔镜 右侧肾上腺肿瘤切除术 

分 类 号：R699.2[医药卫生—泌尿科学]