摘要
目的 探讨后腹腔镜手术治疗肾上腺疾病的适应证及手术方法。 方法 采用后腹腔镜手术治疗肾上腺疾病 5 2例 5 4侧 ,其中原发性醛固酮增多症 37例 38侧 (腺瘤 34例、结节样增生 3例 4侧 ) ;皮质醇增多症 6例 (腺瘤 5例、增生 1例 ) ;嗜铬细胞瘤 3例 4侧 ;无功能腺瘤 4例 ;髓样脂肪瘤 1例 ;肾上腺转移癌 1例。 结果 5 2例 5 4例次手术中 5 1例次成功 ,3例次因术中出血或粘连改行开放手术。手术时间 40～ 2 70min ,平均 135min。术中出血 5～ 15 0ml,平均 45ml,均未输血。镇痛剂用量 0～ 5 0mg ,平均 8.5mg ,其中 17例未用镇痛剂。患者术后 1～ 2d排气后恢复进食并可在床上坐起活动 ,1～ 3d可下床活动。术后住院时间 3～ 14d ,平均 6d。 结论 与开放手术相比 ,后腹腔镜手术具有创伤小、疼痛轻、康复快等优点 ,可望成为肾上腺良性疾病首选手术方法。
Objective To evaluate retroperitoneal laparoscopic adrenalectomy. Methods From June of 1999 to January of 2001, retroperitoneal laparoscopic adrenalectomy was performed on 52 patients with adrenal diseases, including 34 cases of aldosterone-preducing adenoma,3 nodular hyperplasia bilateral in 1, 5 Cushing's syndrom,1 Cushing's disease, 3 adrenal pheochromacytoma (bila- teral in 1), 4 nonfunctional adrenal adenoma, 1 myelolipoma and 1 metastasis carcinoma. Results 54 sessions of retroperitoneal adrenalectomy have been carried out for 52 patients (2 on both sides) with success in 51 procedures. The procedure was converted to open operation in 3 occasions because of bleeding or adhesion. The mean operation time was 135 minutes (40～270 min), and the estimated blood loss 45 ml (5～150 ml) with no need of transfusion. The postoperative hospital stay was 6 d (3～14 d) and the mean analgesia consumed 8.5 mg (0～50 mg) of morphine equivalents with no need of any analgesic at all in 17 patients. Conclusions Retroperitoneal laparoscopic adrenalectomy was less traumatic to the patients, with less postoperative discomfort and quicker recovery. The procedure should be considered as the first choice of therapy for benign adrenal diseases.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2002年第7期389-391,共3页
Chinese Journal of Urology
