经腹腔和经腹膜后入路机器人辅助腹腔镜治疗巨大体积肾上腺肿瘤45例分析  

Robot-assisted transperitoneal and retroperitoneal adrenalectomy for huge adrenal tumors in 45 cases

作　　者：韩毅力[1] 赵佳晖[1] 罗勇[1] 李明川[1] 魏德超 姜永光[1] HAN Yili;ZHAO Jiahui;LUO Yong;LI Mingchuan;WEI Dechao;JIANG Yongguang(Department of Urology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院泌尿外科,北京100029

出　　处：《现代泌尿外科杂志》2023年第1期46-49,58,共5页Journal of Modern Urology

摘　　要：目的比较经腹腔和腹膜后入路行机器人辅助腹腔镜手术治疗巨大体积(>6 cm)肾上腺肿瘤。方法回顾性分析2017年1月-2021年12月机器人辅助腹腔镜手术治疗的45例巨大肾上腺肿瘤患者的临床资料。其中经腹腔入路28例,腹膜后入路17例。结果45例患者均无中转开放手术。腹膜后入路和腹腔入路在手术时间[(130.88±5.96)和(136.61±8.39)min]、失血量[(189.41±13.91)和(192.5±12.36)mL]、术后引流时间[(2.24±0.44)和(2.36±0.49)d]、住院时间[(7.06±0.56)和(7.46±0.69)d]差异无统计学意义。腹膜后入路组首次进食时间更早[(38.82±6.75)和(74.14±6.57)h],差异有统计学意义(P<0.01)。结论机器人手术治疗巨大肾上腺肿瘤安全、有效,手术入路的选择应根据患者情况、肿瘤体积和部位进行。Objective To compare the outcomes of robot-assisted laparoscopic transperitoneal and retroperitoneal operation for huge(>6 cm)adrenal tumors.Methods The clinical data of 45 patients with huge adrenal tumors who underwent robotic surgery during Jan.2017 and Dec.2021 were retrospectively analyzed,including 28 cases via the transperitoneal approach and 17 cases via the retroperitoneal approach.Results No patients were converted to open operations.There were no significant differences in postoperative drainage time(2.24±0.44 vs.2.36±0.49)d,operation time(130.88±5.96 vs.136.61±8.39)min,blood loss(189.41±13.91 vs.192.5±12.36)mL and postoperative hospital stay(7.06±0.56 vs.7.46±0.69)d between the retroperitoneal and transperitoneal approaches.Retroperitoneal approach was better than transperitoneal approach in early postoperative feeding[(38.82±6.75 vs.74.14±6.57)h,P<0.01].Conclusion Robotic surgery is safe and effective in the treatment of large adrenal tumors.The choice of surgical approach should be based on patients condition,tumor volume and location.

关 键 词：巨大肾上腺肿瘤 机器人辅助腹腔镜手术 肾上腺切除术 腹腔入路 腹膜后入路 术后首次进食时间 

分 类 号：R736.6[医药卫生—肿瘤]