后腹腔镜手术切除肾上腺节细胞神经瘤疗效观察

Retroperitoneal laparoscopic operation for adrenal ganglioneuroma

目的 :探讨后腹腔镜微创手术治疗肾上腺节细胞神经瘤的适应证和可行性。方法 :采用后腹腔镜手术治疗肾上腺节细胞神经瘤患者 5例 ,其中左侧肾上腺节细胞神经瘤 2例 ,右侧 3例。结果 :5例后腹腔镜手术全部获得成功 ,4例肾上腺肿瘤为单发 ,1例为多发 (4个肿瘤 ) ;肿瘤最大直径 2 .5～ 8.0 (4 .2± 1.8)cm ;手术时间35～ 10 5 (5 9± 2 7)min ,估计出血量 10～ 30 (19± 7)ml,术后镇痛剂吗啡用量 0～ 2 0 (8± 8)mg ,2例未用镇痛剂 ;排气、恢复进食时间 1～ 3(1.4± 0 .5 )d ;术后住院时间 4～ 7(5 .4± 1.5 )d。无围手术期并发症发生。结论 :后腹腔镜手术切除肾上腺节细胞神经瘤是安全可行的 ,能充分体现腹腔镜手术创伤小、恢复快的优点。肾上腺节细胞神经瘤是腹腔镜手术很好的适应证。

Objective:Report our experience of retroperitoneal laparoscopic surgery for adrenal ganglioneuroma. Methods:From September 2000 to January 2004, 5 patients underwent retroperitoneal laparoscopic excision of adrenal ganglioneuroma, 4 Male and 1 female, 4 to 39(24±14) years old. In this group, 2 patients with left adrenal ganglioneuroma, 3 patient with right adrenal ganglioneuroma.Results:Retroperitoneal laparoscopic adrenalectomy has been succecded in all 5 cases, no complication occurred. Mean tumor size was 4.2 ± 1.8 (tumor diameter 2.5～8)cm. Mean operative time was 59±27 (range, 35～105) min. Mean estimated blood loss was 19±7 (range, 10～30) ml, no one needed blood transfusion. Mean analgesic(morphine equivalents) consumption of 8±8 (range 0～20)mg, while no requirement of analgesic in 2 patients. Postoperative hospital stay was 5.4±1.5(range, 4～7)d.Conclusions:Retroperitoneal laparoscopic surgery for adrenal ganglioneuroma is feasible and safe. Since its less traumatic and quicker recovery, retroperitoneal laparoscopic surgery should be considered as the first choice for adrenal ganglioneuroma.