后腹腔镜下单层面法与解剖性三层面法肾上腺肿瘤切除术的临床疗效对比  

A comparative study of three layers and single-site in retroperitonescopic adrenalectomy

作　　者：刘彦申 陶润 王成勇[1] 关翰 周文生[1] Liu Yanshen;Tao Run;Wang Chengyong(Department of Urology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000)

机构地区：[1]蚌埠医学院第一附属医院

出　　处：《中国现代医药杂志》2019年第11期25-28,共4页Modern Medicine Journal of China

摘　　要：目的对比单层面法与三层面法后腹腔镜肾上腺肿瘤切除术的临床效果。方法回顾性分析我院2017年7月~2019年1月38例后腹腔镜肾上腺肿瘤切除术患者的临床资料,其中18例采用单层面分离法,20例采用解剖性三层面分离法,对比2组手术时间、术中失血量、术后拔管时间、术后住院天数、术中及术后并发症等指标。结果 38例手术全部成功,术中无大出血、中转开腹等,患者均平稳出院。2组手术时间分别为(30.7±4.3)min和(56.5±10.6)min,术中失血量分别为(24.3±2.7)ml和(36.5±3.5)ml,差异均有统计学意义(P<0.05);2组术后拔管时间、术后住院天数、术中及术后并发症等,差异无统计学意义(P>0.05)。结论单层面法比三层面法后腹腔镜肾上腺肿瘤切除术具有手术时间短、术中出血量少、对肾脏周围游离面小、术后与周围组织粘连轻、利于日后再行腹膜后手术等优点。Objective To compare the clinical value of retroperitoneal laparoendoscopic single-site adrenalectomy and three layers for adrenal tumor diseases. Methods A total of 38 patients with adrenal mass underwent operations in our hospital from Jul 2017 to Jan 2019, including 18 cases of retroperitoneal laparoendoscopic single-site adrenalectomy and 20 cases of anatomical retroperitoneoscopic adrenalectomy with three layers. The operative time, intraoperative blood loss, catheter extraction time, postoperative hospital stay, intraoperative and postoperative complications were analyzed between the two groups. Results All the 38 surgeries were performed successfully without severe complications such as bleeding and conversion to open surgery, patients were discharged from hospital smoothly. The clinical data of single-site adrenalectomy group and three layers method group were as following: the average operation time was(30.7±4.3)min and(56.5±10.6)min, the differences were statistically significant(P<0.05);the mean intraoperative blood loss was(24.3±2.7)ml and(36.5±3.5)ml, respectively(P<0.05). There were no significant differences in catheter extraction time, postoperative hospital stay, postoperative complications between single-site adrenalectomy group and three layers method group(P>0.05). Conclusion Retroperitoneal laparoendoscopic single-site adrenalectomy has the advantages of shorter operation time, less intraoperative blood loss and smaller free surface around the kidney. It’s good for future surgery.

关 键 词：后腹腔镜 解剖性三层面 单层面 肾上腺肿瘤切除术 

分 类 号：R73[医药卫生—肿瘤]