肾上腺囊肿16例诊疗分析

Diagnosis and treatment of adrenal cyst:report of 16 cases

目的提高肾上腺囊肿的诊断和治疗水平。方法回顾性分析2005年1月至2010年12月16例经病理确诊肾上腺囊肿的临床资料。结果超声诊断肾上腺囊肿的准确率为60%,CT诊断肾上腺囊肿的准确率为66.7%。本组15例经后腹腔镜手术治疗,其中5例行后腹腔镜肾上腺囊肿切除,10例因囊肿与肾上腺黏连无法分离行肾上腺切除术。另外1例为2岁儿童行开放肾上腺囊肿切除手术治疗。后腹腔镜手术时间平均(65.5±21.5)min,术中出血平均(30.5±11.5)ml,术后平均住院(4.7±1.8)d。手术均顺利,术中均未输血,无手术死亡病例。术中血压均无明显波动。术后病理:内皮囊肿占50%,假性囊肿占31.3%,上皮囊肿占19.7%,未发现寄生虫性囊肿。术后随访6个月至3年,无一例复发,无肾上腺功能减退病例。结论加强对肾上腺囊肿的认识有助于提高肾上腺囊肿诊断的准确率。后腹腔镜手术是肾上腺囊肿安全有效的治疗方法。

Objective To improve the diagnosis and management of adrenal cyst.Methods From Jan 2005 to Dec 2010, data of 16 cases with pathological confirmed adrenal cysts were reviewed retrospectively.Results The accurate diagnosis rate of adrenal cysts by ultrasonography was 60% compared to 66.7% by Computed Tomography scan. Fifteen cases were undergone with retropernitoneal laparoscopic surgery. Among them, 5 cases received retropernitoneal laparoscopic resection of adrenal cysts, and 10 retropernitoneal laparoscopic adrenectomy. Only one child received open resection of adrenal cyst. The operations were successful in all 16 patients without any transfusion. The mean operative time for retropernitoneal laparoscopic procedure was (65.5±21.5) minutes, the mean intraoperative bleeding was (30.5±11.5)ml and the mean hospitalization postoperatively was (4.7±1.8) days. There were no serious complications in perioperative period and no recurrence during 6 months to 3 years follow-up.Conclusions Well understanding of adrenal cyst is helpful to improve the diagnosis of this disease.Retroperitoneal laparoscopic surgery is feasible and safe to manage adrenal cysts.