腹腔镜手术治疗肾上腺嗜铬细胞瘤(附24例报告)

Laparoscopic surgery for adrenal pheochromocytoma: report of 24 cases

目的评价腹腔镜手术治疗肾上腺嗜铬细胞瘤的安全性及临床价值。方法对24例肾上腺嗜铬细胞瘤患者采用腹腔镜经腹腔途径手术治疗。结果23例手术取得成功，1例因粘连严重、术中出血改行开放手术。肿瘤最大径2．5～8cm，平均4．2cm；手术时间30～150min，平均70min；术中出血量20～200ml，平均50ml，均未输血；术后住院5～10d，平均6．8d；术后病理检查证实均为肾上腺嗜铬细胞瘤。全部病例获得随访3～18个．月，平均10个月，患者血压正常，B超或CT复查均未见肿瘤复发。结论对于直径〈6cm的肾上腺嗜铬细胞瘤，腹腔镜手术具有手术时间短、出血少、损伤小、恢复快、安全性高、并发症少等优点，可替代开放手术。

[Objective] To evaluate the safety and application of laparoscopic surgery for adrenal pheochromocytoma. [Methods] Clinical records of 24 cases of laparoscopic adrenalectomy of pheochromocytom from October 2004 to December 2005 were reviewed. [Results] Success was achieved in 23 cases while in the other one the procedure was transferred to open surgery because of bleeding. The largest dimension of the tumor was 2. 5-8 （mean 4.2） cm. The operative time was 30-150 （mean 70） rain. The volume of blood loss was 20 -200 （mean 50） ml with no blood transfusion. The postoperative hospital stay was 5- 10 （mean 6. 8） days. Pathological examination revealed adrenal pheochromocytoma in all cases. All cases were followed up for 3-18 （mean 10） months, In all patients blood pressures were normal and no residual tumors were found by Bultrasonography or CT scans after laparoscopic surgery. [ Conclusion ] Laparoscopic surgery for pheochromocytoma is feasible and safe, without increasing the operation risks for tumors smaller than 6 cm. Because of its less traumatic and more rapid recovery, laparoscopic adrenalectomy can be considered the preferred choice for pheochromocytoma.