摘要
目的探讨后腹腔镜手术在肾上腺肿瘤治疗中的临床价值。方法回顾性分析我院2006年1月—2011年1月收治的152例肾上腺肿瘤患者的临床资料,其中行后腹腔镜肾上腺肿瘤切除术100例(后腹腔镜手术组),开放肾上腺肿瘤切除术52例(开放手术组),对比两组手术时间、术后进食时间、术后住院天数、输血及并发症发生情况。采用SPSS 13.0统计软件包进行分析处理。结果后腹腔镜手术组患者手术时间、术后进食时间、术后住院天数较开放手术组均明显缩短,差异有统计学意义(P<0.05)。后腹腔镜手术组1例(1.0%)术中输血,共输红细胞4 U;开放手术组8例(15.4%)术中输血,共输红细胞32 U、血浆1 600 ml。两组术中输血率比较差异有统计学意义(χ2=14.474,P<0.05)。开放手术组5例术中出现并发症,包括胸膜损伤3例、大出血2例;4例术后出现并发症,其中2例切口脂肪液化,1例切口对合不齐切口愈合欠佳,1例切口感染伴切口裂开。后腹腔镜手术组术中、术后未见明显并发症。结论后腹腔镜手术优于开放手术,可作为肾上腺肿瘤的首选术式,具有创伤小、恢复快、安全、有效的特点。后腹腔镜手术时间可随着手术技巧的逐步提高而极大缩短。手术成功的关键与术前药物治疗、肿瘤定位、患者全身状况改善以及麻醉师术中配合密切相关。
Objective To investigate the clinical value of retroperitoneal laparoscopic in the treatment of adrenal tumor. Methods Clinical data of 152 patients with adrenal tumor admitted to our hospital from January 2006 to January 2011 were retrospectively analyzed. Among the patients, 100 cases were given retroperitoneal laparoscopic excision （ retroperitoneal laparoscopic group） and 52 cases were given open surgery excision （ open surgery group） . Operation time, postoperative feeding time,postoperative hospitalization, blood transfusion and complications of the two groups were compared. SPSS 13.0 software was used to analyze and process the data. Results The operation time, postoperative feeding time and postoperative hospitalization of retro- peritoneal laparoscopic group were all significantly reduced compared with those of the open surgery group （ P 〈 0.05 ） . One case （ 1.0% ） in retroperitoneal laparoscopic group was given blood transfusion of 4 U red blood cell. 8 cases （ 15.4% ） in open surgery group was given blood transfusion of 32 U red blood cell and 1 600 ml blood plasma. The blood transfusion rate of the two groups showed statistically significant difference （ ~2 = 14. 474, P 〈 0.05 ） . 5 cases in open surgery group had intraoperative complica- tions, including 3 cases of pleural injury and 2 cases of massive hemorrhage. 4 cases had postoperative complications, including 2 cases of incision fat liquefaction, one case of unsatisfactory incision healing and one case of incision infection accompanied with incision split. No obvious intraoperative and postoperative complications were found in retroperitoneal laparoscopic group. Conclusion Retropefitoneal laparoseopic surgery is better than open surgery with minimal invasion, rapid recovery, good safety and efficacy and can be taken as the first - choice surgery for adrenal tumor. The time of retroperitoneal laparoscopic surgery can be significantly reduced with the improving of surgery techniques. The key for a successful surgery is closely related to preoperative drug therapy, tumor location, improvement of the patients＇ general condition and the intraopeartive eooperation with analgesist. [ Key words ] Adrenal gland neoplasms ; Adrenalectomy ; Laparoscopy
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第27期3177-3179,共3页
Chinese General Practice
