肾上腺肿瘤保留肾上腺组织的手术技巧及应用价值(附97例报告)  

Application value and techniques of adrenal-sparing surgery (report of 97cases)

作　　者：周高峰[1] 柳懿鹏[1] 刘双林[1] 吕磊[1] 吴维[1] 黄遂斌[1] 袁敬东[1] 章传华[1] ZHOU Gao-feng;LIU Yi-peng;LIU Shuang-lin;LV Lei;WU Wei;HUANG Sui-bin;YUAN Jing-dong;ZHANG Chuan-hua(Department of Urology, First Hospital of Wuhan, Wuhan 430022, China)

机构地区：[1]湖北省武汉市第一医院泌尿外科,430022

出　　处：《现代泌尿生殖肿瘤杂志》2017年第4期198-201,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨肾上腺肿瘤手术中保留正常肾上腺的安全性及应用价值。方法回顾性分析2006年1月至2016年12月于我科接受保留肾上腺组织的肾上腺手术治疗的97例肾上腺肿瘤患者的临床资料,肿瘤位于左侧50例、右侧32例、双侧15例,肿瘤平均直径2.3(0.9~4.6)cm,97例中醛固酮腺瘤58例、Cushing综合征12例、嗜铬细胞瘤5例、无功能腺瘤22例。结果所有患者手术均成功,手术时间平均71min;术中失血量平均36ml;术后住院天数平均4.2d。随访3~48个月,患者临床症状消失,残存肾上腺组织功能良好,均不需要激素替代治疗。结论对于体积较小的肾上腺肿瘤患者,施行肾上腺肿瘤切除手术时保留正常肾上腺组织,安全性高,疗效良好,可避免患者术后需长期激素替代治疗而带来的危害,值得临床推广。Objective To evaluate the safety and application value of retaining normal adrenal gland in surgery of adrenal tumors.MethodsThe retrospective analysis was made on the clinical data of97patients who underwent retroperitoneal laparoscopic adrenal sparing surgery from Jan.2006to Dec.2016.The mean size of the adrenal tumours was2.3(range,0.94.6)cm,and was on the left side in50cases,the right side in32,and bilateral tumors in15.Primary hyperaldosteronism was found in58cases,Cushing's syndrome was found in12cases,phaeochromocytoma was found in5cases,and nonfunctional adenoma was found in22cases.ResultsAll the patients underwent the operation successfully.The mean operative time was71minutes.The mean blood loss was36ml.The mean postoperative hospital stay was4.2days.Over the follow up period of348months,patients'clinical symptoms all disappeared,the functions of remaining adrenal glands were good,and no patient required steroid replacement.ConclusionsAdrenal sparing procedure in adrenalectomy for small adrenal tumor is safe,effective and feasible.The function of remaining adrenal gland can be reserved to avoid the danger of long term steroid replacement.

关 键 词：肾上腺 肿瘤 腹腔镜 

分 类 号：R736.6[医药卫生—肿瘤]