后腹腔镜肾上腺切除与部分肾上腺切除治疗醛固酮瘤的疗效比较

The comparision of theraputic effect between retroperitoneal laparoscopic total and partial adrenalectomy for aldosterone adenoma

目的:比较后腹腔镜肾上腺全切与部分切除术治疗醛固酮瘤患者的疗效.方法:2008~2012年间对61例醛固酮瘤患者中的47例行肾上腺部分切除术,14例行肾上腺全切术,统计醛固酮瘤患者资料,比较两组患者的基本特征,手术资料,手术并发症和术后随访结果.结果:行后腹腔镜肾上腺部分切除术组的患者性别比例、体重指数、肿瘤直径、术前血压、术前血钾和血醛固酮浓度与行后腹腔镜肾上腺全切术组患者均无显著差异,其中患者平均年龄前者大于后者,两组患者在手术时间、术中出血量、术后住院时间、引流时间和引流量均无显著差异,随访结果表明两组患者术后血钾和血压均恢复或改善,血钾水平两组无显著差异,血压部分切除组较全切组水平低(P=0.014 1,P=0.015 7) 结论:后腹腔镜肾上腺部分切除术技术上安全,对治疗醛固酮瘤患者可与后腹腔镜肾上腺全切术达到同等治疗效果.

Objective:To compare the therapeutic effect of retroperitoneal laparoscopic total and partial adrenalectomy in patients with aldosterone adenoma.Methods:In the 61patients with aldosteronoma who were operated during 2008to 2012,61patients received laparoscopic partial adrenalectomy while 14patients received laparoscopic total adrenalectomy.We analyzed the data of all patients and compared the characters,BMI,complications and follow-up data between the two groups.Results:There were no significant difference between sex composition,BMI,tumor diameter,preoperative blood pressure,plasma potassium concerntration and plasma aldosterone concerntration except for the greater age in the former group.The average operative time,bleeding volume,postoperative hospital stay, drainage duration and drainage volume between two groups still didn't show significant difference.The follow-up data showed that all the patients in the two groups achieved recovering or improvement.No significant difference in the potassium level was observed between the two groups and patients in the partial adrenaletomy group have lower postoperative blood pressure(P=0.014 1,P=0.015 7)Conclusions:Retroperitoneal laparoscopic partial adrenalectomy is technically safe,and can achieve equal therapuetic effect with total adrenalectomy for patients with aldosterone adenoma.