| 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6月，采用腹腔镜手术治疗肾上腺肿瘤203例；男128例，女75例；年龄21～74岁，平均（45±2）岁；双侧6例。肾上腺肿瘤或结节直径0.4～18 cm。结果：203例患者，行肾上腺手术209例次，其中经后腹腔166例，经腹34例，手助腹腔镜3例，腔镜手术成功197例，有6例(2.96%)中转开放手术。手术时间为25～275 min，平均（135±35） min。术中出血40～250 ml，平均（75±25） ml。术后1～3 d可下床活动。术后住院时间7～10 d，平均（7±2） d。手术并发症为腔静脉损伤1例，胸膜损伤1例，腰部血肿4例，Trocar穿刺口脂肪液化1例。结论：经后腹腔腹腔镜途径治疗肾上腺肿瘤具有一定的优势，但需根据肿瘤大小和病理类型严格掌握，对肿瘤体积较大、肥胖或有双侧病变患者时选择经腹途径较为合适。 |
| 关键词: 肾上腺肿瘤 腹腔镜外科手术 肾上腺切除术 |
| DOI：10.3724/SP.J.1008.2007.01056 |
|
| 基金项目:上海市科委基金(014119042, 054119604). |
|
| Laparoscopic adrenalectomy: an experience with 203 cases |
| ZHENG Junhua1*, PENG Bo1, XU Yunfei1, XU Danfeng2, GAO Yi2 , CUI Xingang2 |
| (1.Department of Urology, The 10th People’s Hospital of Shanghai, Tongji University, Shanghai 200072，China; 2.Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai 200003) |
| Abstract: |
| Objective：To summarize our experience on laparoscopic adrenalectomy.Methods: From August 2001 to Jun 2007, a total of 203 patients (128 male and 75 female, aged 2174 years, with a mean of \[45±2\] years old) received laparoscopic adrenalectomy. Six patients had bilateral tumors. The diameters of the adrenal tumors or nodules were 0.418 cm. Results: The 203 patients received a total of 209 times of laparoscopic adrenalectomy: including 34 cases via transperitoneal approach, 166 via retroperitoneal approach and 3 via handassisted approach. The overall successful rate of laparoscopic adrenalectomy was 97.04% (197/203). Six persontimes (2.96%) were converted to open operation due to bleeding or adhesion. The mean operation time was 135±35 min and the estimated blood loss was 40250 ml (with a mean of 75±25 ml). The patients could get down the bed for activity 13 days after operation. The postoperative hospital stay was 710 days (with a mean of 7±2 days). The complications included vena caval injury (1 case), pleural injury (1 case), lumbar hematoma (4 cases), and fat liquefaction (1 case).Conclusion: Laparoscopic adrenalectomy has 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 larger tumors, for obese patients or for patients with bilateral lesions. |
| Key words: adrenal gland neoplasms laparoscopic surgical procedures adrenalectomy |
