摘要
目的总结腹腔镜手术治疗肾上腺肿瘤的经验。方法2001年8月至2007年10月,我们采用腹腔镜手术治疗肾上腺肿瘤272例。其中男175例,女97例。年龄21～74岁,平均45±2岁。肾上腺肿瘤直径0.4～18 cm。结果本组272例,行腹腔镜肾上腺肿瘤切除术284例次,其中腹腔镜手术切除成功266例,有6例次(2.96%)中转开放手术。手术时间45～275 min,平均135±35 min。术中出血40 ml～250 ml,平均75±25 ml。术后住院时间7～10 d。手术并发症为腔静脉损伤1例,胸膜损伤2例,腰部血肿8例,Trocar穿刺口脂肪液化6例。结论腹腔镜手术治疗肾上腺肿瘤创伤小,并发症少,安全有效,患者术后恢复快。对于直径大于6 cm的肿瘤也可采用腹腔镜手术切除,但要求手术医师有比较丰富的腹腔镜手术技巧和经验。
Objective To summary the experiencs of laparoscopic adrenalectomy. Methods From August 2001 to October 2007, a total of 272 patients （175 male and 97 female, age 21-74 years, with a mean of 45±2 years old） underwent laparoscopic adrenalectomy. 12 patients had bilateral tumors. The diameters of the adrenal masses or nodules were 0.4-18 cm.Results The 272 patients received a total of 284 times of laparoscopic adrenalectomy; including 54 cases via a transperitoneal approach, 208 via retroperitoneal approachand and 10 via hand-assisted approach. The overall successful rate of laparoscopic a-drenalectomy was 97.79%（266/272）. Six patients （2.21%） were converted to open operation due to bleeding or adhesion. The mean operation time was 135±35 min, and the estimated blood loss was 40±250ml（with a mean of 75±25 ml）. The patients could get down the bed for activity 1-3 days after operation. The postop-erative hospital stay was 7-10 days. The complications included vena caval injury （1 case）, pleural injury（2 cases）and lumbar hematoma（8 cases）, and fat liquefaction（6 cases）. Conclusion Laparoscopic adrenalecto- my has its advantages for treating adrenal tumors. But different approaches should be chosen according to the size and pathological types of the tumors. Transperitoneal approach should be chosen for patients with large tumors, obese patients or patients with bilateral lesions.
出处
《中华腔镜泌尿外科杂志（电子版）》
2009年第6期4-6,共3页
Chinese Journal of Endourology(Electronic Edition)
基金
上海市科委医学引导项目(074119618)
关键词
腹腔镜
肾上腺肿瘤
手术
Laparoscopy
Adrenal masses
Surgery
