| 摘要: |
| 目的总结直径≥10 cm肾上腺肿瘤的腹腔镜手术的手术要点及临床经验。方法2011年6月至2012年9月对5例直径≥10 cm的肾上腺肿瘤实施了腹腔镜切除术,观察临床效果,并分析和总结手术入路、操作技巧。结果5例腹腔镜下≥10 cm肾上腺肿瘤切除术均顺利完成,均为经腹腔入路,无术中、术后并发症,手术时间130~270 min,平均(180±65) min,术中出血50~300 ml。术后2~3 d排气,5~7 d出院。病理结果:嗜铬细胞瘤1例,肾上腺皮质腺瘤1例,神经鞘瘤1例,髓质脂肪瘤2例。结论在技术娴熟的基础上,结合准确的手术入路、舒适的穿刺套管位点、充分的手术视野暴露、完整地分离“三个平面”及安全地处理“危险三角”等技术要点,直径≥10 cm肾上腺肿瘤不再是腹腔镜手术的禁忌证。 |
| 关键词: 腹腔镜检查 肾上腺肿瘤 肾上腺切除术 |
| DOI：10.3724/SP.J.1008.2012.001381 |
| 投稿时间：2012-11-05修订日期：2012-12-03 |
| 基金项目: |
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| Laparoscopic adrenalectomy for adrenal tumor with diameter longer than 10 cm: an experience with 5 cases |
| WANG Hui-qing△,YANG Bo△,XU Bin△,GUO Fei,LIU Hong-hui,XU Chuan-liang,SUN Ying-hao* |
(Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors.
*Corresponding author.) |
| Abstract: |
| ObjectiveTo summarize our clinical experience on laparoscopic adrenalectomy for ≥10 cm adrenal tumors. MethodsFrom June 2011 to September 2012, 5 patients received laparoscopic adrenalectomy for ≥10 cm adrenal tumors in our department. The outcomes of patients were observed. The surgical approach, Trocar sites, exposure of operation field, and the management of “dangerous triangle” were all summarized and analyzed. ResultsAll the 5 cases were successfully operated via intraperitoneal approach, with no complications during or after operation. The operation time was 130-270 min (a mean of \[180±65)\] min), the bleeding was 50-300 ml, the anal exhaust time was 2-3 d after operation, and the hospital stay was 5-7 d. Pathological reports included 1 pheochromocytoma, 1 adrenal cortical adenoma, 1 schwannoma, and 2 myelolipoma. ConclusionAdrenal tumor with diameter ≥ 10 cm is no longer a contraindication for performing laparoscopic adrenalectomy when the followings are ensured: highly skilled, accurate surgical approach, comfortable Trocar sites, full exposure of operative field, complete separation of the “three planes”, and safe management of the “dangerous triangle”. |
| Key words: laparoscopy adrenal gland neoplasms adrenalectomy |
