后腹腔镜手术治疗肾上腺囊肿15例报告

Retroperitoneoscopic surgery for adrenal cysts: A report of 15 cases

目的探讨后腹腔镜手术治疗肾上腺囊肿的方法及临床意义。方法2000年3月～2004年5月我院对15例肾上腺囊肿均采用后腹腔镜手术治疗。扩张后腹膜间隙成功后,紧靠膈下纵形切开肾周筋膜,肾周筋膜内分离肾上极和肾上腺周围的脂肪组织,超声刀或电刀在肾表面分离肾脏上极和肾上腺。游离肾上腺行肾上腺部分切除或全切除。结果15例手术均获成功,其中肾上腺部分切除术12例,肾上腺全切术3例。手术时间(49.0±31.4)min,术中出血量(31.6±28.7)ml,住院时间(4.1±1.4)d。除1例术后伤口皮下气肿外,无其他术后并发症。15例术后随访(18.5±1.0)月(12～36个月),无一例复发。结论后腹腔镜手术可作为肾上腺囊肿的首选治疗方法。

Objective To evaluate the operative methods and clinical significance of retroperitoneoscopic operation for adrenal cysts. Methods Clinical data of 15 patients with adrenal cyst treated by retroperitoneoscopic operations in this hospital from March 2000 to May 2004 were analyzed retrospectively.After the retroperitoneal space was dilated,the perinephric fascia was opened longitudinally near the diaphragm.The adipose tissues around the upper polar of the kidney and the adrenal gland were dissected.Then the upper polar of the kidney and the adrenal gland were exposed alongside the renal surface,by using a harmonic scalpel or an electrotome,to perform partial or total adrenalectomy. Results All the 15 operations were successfully conducted, including 12 cases of partial adrenalectomy and 3 cases of total adrenalectomy. The mean operative time was 49.0±31.4 min, the mean blood loss was 31.6±28.7 ml, and the mean hospital stay, 4.1±1.4 d. No postoperative complications were seen except for 1 case of subcutaneous emphysema. Follow-up for 18.5±1.0 months (range, 12~36 months) in all the patients found no recurrence. Conclusions Retroperitoneoscopic operation can be used as the first choice for the treatment of adrenal cysts.