6月龄以下婴儿肾上腺区肿物后腹腔镜手术体会  

Experience of Retroperitoneoscopy for Adrenal Masses in Infants Under 6 Months Old

作　　者：赵华善 翟允鹏[1] 郭锐[1] 许洪修 黄赛 吕龙飞 张士松[1] Zhao Huashan;Zhai Yunpeng;Guo Rui(Department of Thoracic and Oncological Surgery,Children’s Hospital Affiliated to Shandong University,Jinan Children’s Hospital,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院济南市儿童医院胸外肿瘤外科,济南250022

出　　处：《中国微创外科杂志》2024年第5期379-383,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：2023年度济南市卫生健康委员会科技计划项目(2023-2-132,2023-2-129);山东大学附属儿童医院高水平科研项目(SDFE-GCC2023005)。

摘　　要：目的探讨后腹腔镜治疗6月龄以下婴儿肾上腺区肿物的可行性。方法2020年1月~2023年11月,对5例6月龄以下的肾上腺区肿物行后腹腔镜手术,年龄1月18天~4月27天,体重5~8 kg。1例产检超声发现,4例出生后其他原因腹部超声发现。超声和CT提示肾上腺区肿物直径1.7~5.5 cm。结果手术均在后腹腔镜下完成,行肾上腺+肿瘤切除术,手术时间65~135 min,中位数94 min,术中出血量<10 ml,引流管留置时间3~6 d,中位数5 d。病理诊断肾上腺神经母细胞瘤4例,肾上腺增生1例。随访1~36个月,中位数3个月,复查腹部彩超、CT等未见复发、转移。结论对于6月龄以下婴儿肾上腺区肿瘤(瘤体边界尚可者),后腹腔镜手术相对安全。Objective To investigate the feasibility of retroperitoneoscopy in the treatment of adrenal masses in infants under 6 months old.Methods From January 2020 to November 2023,retroperitoneoscopic surgery was performed in 5 infants under 6 months old with adrenal tumors.Their age was from 1 month and 18 days to 4 months and 27 days,and their body weight was 5-8 kg.The lesion was found by prenatal ultrasonography in 1 case and by abdominal ultrasonography for other reasons after birth in 4 cases.Ultrasound and CT indicated a diameter of 1.7-5.5 cm for the adrenal masses.Results The operations of adrenalectomy and tumor resection were completed under retroperitoneoscopy.The operative time was 65-135 min(median,94 min).The intraoperative blood loss was less than 10 ml.The postoperative drainage tube retention time was 3-6 d(median,5 d).Pathological diagnosis showed 4 cases of adrenal neuroblastoma and 1 case of adrenal hyperplasia.Follow-ups for 1-36 months(median,3 months)with abdominal ultrasound and CT scanning showed no recurrence or metastasis.Conclusion Retroperitoneoscopy is relatively safe for the treatment of adrenal tumors in infants under 6 months old(tumors with acceptable boundaries).

关 键 词：后腹腔镜手术 婴幼儿 肾上腺区 

分 类 号：R736.6[医药卫生—肿瘤]