不同入路腹腔镜肾上腺肿瘤切除术治疗功能性肾上腺肿瘤的对比分析  

Comparative analysis of different approaches to laparoscopic adrenal tumor resection for functional adrenal tumors

作　　者：吴蓉蓉 高嵩 WU Rongrong;GAO Song(Lishui People's Hospital,Zhejiang 323000,China)

机构地区：[1]浙江省丽水市人民医院,丽水323000

出　　处：《浙江创伤外科》2025年第2期216-219,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的对比两种不同入路腹腔镜肾上腺肿瘤切除术对功能性肾上腺肿瘤的应用效果。方法回顾性选取本院2021年5月至2024年6月期间所收治的功能性肾上腺肿瘤患者114例作为研究对象,按照不同入路方式分为对照组[行经腹腔入路腹腔镜肾上腺肿瘤切除术(TLA)]53例、研究组[行后腹腔入路腹腔镜肾上腺肿瘤切除术(RLA)]61例。对比两组手术相关指标、肾功能相关指标、氧化应激指标及电解质水平。结果与对照组相比,术后研究组HCO_(3)^(-)、谷胱甘肽过氧化物酶(GSH-Px)、Na^(+)水平降低,晚期氧化蛋白产物(AOPP)、K^(+)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平升高,差异具有统计学意义(P<0.05)。且研究组引流量、治疗费用、手术时间、引流管留置时间、通气时间均优于对照组,差异具有统计学意义(P<0.05)。结论TLA及RLA均为治疗功能性肾上腺肿瘤的有效方法,均未发生肾上腺皮质功能不全及肾上腺危象情况,但RLA手术时间短且术后恢复快,更具经济性。Objective To compare two different approaches to laparoscopic adrenal tumor resection for functional adrenal tumors.Methods A total of 114 patients with functional adrenal tumors admitted to our hospital between May 2021 and June 2024 were retrospectively selected as the study subjects,and divided into 53 cases in the control group(laparoscopic adrenal tumor lobectomy(TLA)via transabdominal approach)and 61 cases in the study group(laparoscopic adrenal tumor lobectomy(RLA)via retroperitoneal approach)according to the different access modes.Surgery-related indexes,renal function-related indexes,oxidative stress indexes and electrolyte levels were compared between the two groups.Results Postoperatively,HCO3-,glutathione peroxidase(GSH-Px),and Na+levels were decreased,and late oxidized protein product(AOPP),K+,superoxide dismutase(SOD),and malondialdehyde(MDA)levels were increased in the study group compared to the control group,and the difference was statistically significant(P<0.05).And the drainage volume,treatment cost,operation time,drainage tube retention time and ventilation time of the study group were better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Both TLA and RLA are effective treatments for functional adrenal tumors,and no adrenocortical insufficiency or adrenal crisis occurred in any of them.However,RLA is more economical because of its shorter procedure time and quicker postoperative recovery.

关 键 词：腹腔入路 后腹腔入路 氧化应激 腹腔镜肾上腺肿瘤切除术 

分 类 号：R736.6[医药卫生—肿瘤]