后腹腔镜肾上腺手术后复发原因分析

Analyzing the reasons of recurrence after retroperitoneal laparoscopic adrenalectomy

目的探讨后腹腔镜肾上腺手术术后复发的原因及预防对策。方法随诊并分析1997～2005年247例后腹腔镜肾上腺良性肿瘤切除手术中复发病例的不同特点、原因以及处理方式,总结预防的措施。结果随诊6个月～8年,247例手术中共出现术后复发6例,占2.4%。其中复发时为恶性肿瘤3例,皮质腺增生1例,醛固酮增多症1例,其他1例。结论后腹腔镜肾上腺手术后有一定的复发比例,复发的原因大部分与操作无关,通过积累经验,复发率可以控制在低水平。

[Objective] To analyse the reasons of recurrence after retroperitoneal laparoscopic adrenalectomy, [Methods] Summing-up the kinds and number of the recurrence after 228 cases of retroperitoneal laparoscopic adrenalectomy. Analyse the reasons and character of these cases. [Results] We followed up these cases for 6 monthes to 8 years. There were 6 recurrent cases in this group （2.4%）, including malignant tumor （3 cases）, adrenal hyperplasia （1 case）, primary aldosteronism （1 case）, unclear case （1 case）. Malignant conversion, tumor leaving out and tumor planting were important reasons of recurrence. [ Conclusions ] There are a few recurrent cases in retroperitoneal laparoscopic adrenalectomy. A majority of these reasons are independent of manipulation. Improving our technique, the ratio of recurrence can be controlled in low level.