后腹腔镜下左侧单层面肾上腺切除术的临床研究(附13例报告)

A Clinical Study of 13 cases in Single Layer Separation Retroperitoneoscopic Adrenalectomy

目的总结后腹腔镜下左侧单层面肾上腺切除的临床经验和优势。方法回顾性分析2018年3月至2018年10月收治的13例行经后腹腔镜下左侧单层面肾上腺切除患者的临床资料,男7例,女6例。年龄34～68岁,平均45. 6岁。肿瘤均位于左侧。肿瘤直径1. 5～3. 0 cm,平均2. 5 cm。体重指数(BMI)<24 kg/m^2者9例,BMI≥24 kg/m^2者2例,合并同侧肾囊肿2例。结果本组13例手术均顺利完成,其中肾上腺全切除术9例,肾上腺次全切除术4例。手术时间35～65min,平均50min。术中出血量5～50ml,平均20ml,术中出现并发症1例(腹膜破裂)。术后住院3～7天,平均6天。术后病理诊断:皮质腺瘤或皮质腺瘤伴结节样增生。结论后腹腔镜下左侧单层面肾上腺切除安全、有效,保留几乎完整的肾脂肪囊,对肾脏影响小,对肥胖患者中具有一定的优势。

Objective To study the clinical outcome of the single layer separation retroperitoneoscopic adrenalectomy. Methods The clinical data of 13 patients with adrenal tumor treated by retroperitoneoscopic adrenalectomy from March 2018 to October 2018 were retrospectively reviewed. There were 7 male and 6 female. The mean age was 45. 6 years,ranged from 34 to 68. All the adrenal tumors located at left side. The average diameter was 2. 5 cm,ranged from 1. 5 to 3. 0 cm. There were 9 cases with body mass index( BMI) < 24 kg/m^2,and the BMI of 2 cases were over 24 kg/m^2,and 2 cases with ipsilateral renal cyst. Results All the 13 cases of the operation were successfully completed. There were 9 cases of total adrenalectomy and 4 cases of subtotal adrenalectomy. The mean operative time was 50 minutes,ranged from 35 to 65 minutes. The estimated blood loss was20 ml,ranged from 5 to 50 ml. 1 case of complications occurred during the operation( peritoneal rupture). The mean postoperative hospital stay was 6 days,ranged from 3 to 7 days. The postoperative pathological diagnosis were the cortical adenoma or the cortical adenoma with nodular hyperplasia. Conclusions Laparoscopic left unilateral adrenalectomy is safe and effective,which retains almost intact renal fat sac,which has little effect on the kidney and has certain advantages for obese patients.