摘要
目的探讨后腹腔镜下肾上腺嗜铬细胞瘤切除术的安全性及治疗效果。方法行后腹腔镜肾上腺嗜铬细胞瘤切除术37例病例资料。肿瘤位于左侧14例,右侧22例,双侧1例。肿瘤直径0.8～8.9 cm,平均4.1±2.2 cm。4例(13.2%)血压正常,33例(86.8%)血压升高,以头晕、头痛、心悸、恶心、呕吐、腹痛等为主要临床表现,典型三征症患者5例。术前将红细胞比容控制在45%以下,心率90次/min,血压在正常范围后,连续监测3 d血压无明显波动后在全身麻醉下行后腹腔镜下肾上腺嗜铬细胞瘤切除术。结果36例手术成功,1例中转开放手术。手术时间143±16 min,术中估计出血量96±34 m1。术后住院时间5±2 d。术中术后未发生重大并发症,肿瘤局部无复发。结论后腹腔镜下肾上腺嗜铬细胞瘤手术具有微创、出血少、恢复快等优点,充分的术前准备、正确的术中操作是取得手术成功、减少术后并发症的关键。
Objective To evaluate the efficacy and safety of retropertoneoscopic adrenalectomy for the treatment of pheochromocytoma. Methods 37 retroperitoneoscopic adrenalectomies for pheochromocytoma were performed, 14 tumors were on the left side, 22 were on the fight and 1 bilateral.The mean tumor size was 4.1±2.2 cm in diameter（range, 0.8 to 8.9 cm）.33 patients mainly presented hypertension, and 4 cases had no hypertension,with chief complaints of dizziness,headache,palpitation,nausea, vomiting and abdominal pain. 5 patients had typical Triple-Symptom Complex. The preoperative preparations included controling the HCT no more than 45% and the heart rate less than 90 times per minitue respectively, modulating the blood pressure in normal range and stabilization in 3 days. Results 36 operations were completed successfully with 1 patient converted to open surgery. The mean operating time was 143±16 min （range： 78 to 420 min）. Estimated blood loss was 96±34 ml. Mean hospital stay after operation was 5±2 days. No major intraoperative complications occurred.There were no mortalities or recurrences of tumor. Conclusions As long as preoperative preparations are adequate and intraoperative manipulations are careful, adrenalectomy for pheochromocytoma could be a safe and minimally invasive procedure.
出处
《中华腔镜泌尿外科杂志（电子版）》
2009年第6期13-15,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
嗜铬细胞瘤
肾上腺切除术
腹腔镜
后腹膜腔
Pheochromocytoma
Adrenalectomy
Laparoscopy
Retroperitoneal space
