后腹腔镜和开放手术治疗肾上腺肿瘤的疗效对比分析

Comparative study on retroperitoneal laparoscopic adrenectomy and open adrenectomy

目的探讨后腹腔镜和开放手术治疗肾上腺肿瘤的临床疗效。方法46例开放手术和22例后腹腔镜治疗肾上腺肿瘤患者的临床病例资料,对两者在手术时间、术中平均出血量等指标进行比较。结果腹腔镜组在术后进食活动时间(2.86±0.48d,3.3±0.84d,P<0.01)、术后拔除引流管时间(3.05±0.38d,3.89±1.28d,P<0.01)和术中出血量(Z=-0.229,P<0.05)优于开放手术组,差异有统计学意义。两组在手术时间(142.7±69.4min,129.1±61.8min,P(0.05)、术后引流量(114.29±59.46ml,125.56±72.1ml,P(0.05)、术后住院时间(6.62±0.92d,7.50±1.34d,P(0.05)和并发症发生率(13.6%,32.6%,P(0.05)等方面的差异无统计学意义。结论后腹腔镜手术治疗肾上腺肿瘤安全有效,因其损伤小、恢复快,可作为肾上腺肿瘤手术的首选方法。

Objective To compare and evaluate the clinical effects between retroperitoneal laparoscopic adrenectomy and open adrenectomy for the treatment of adrenal diseases. Methods The clinical data of 46 open adrenalectomies and 22 LAs were performed for patients with adrenal tumors from 2005 to 2007. The differences in operation time, the bleeding volume during operation, the time before having food, the time of pulling out the drainage tube after operation, hospitalization stay after operation and the complication rates were analyzed. Results The differences in bleeding volume during operation （Z = - 0.229, P 〈 0.05 ） the time before having food （2. 86 ± 0.48d, S 3.3 ± 0.84d, P 〈 0.01 ） and the time of pulling out the drainage tube after operation than （3.05 ± 0.38 d, 3.89 ± 1.28d, P 〈0.01 ） was significant. There were no significant differences in terms of the operation time （142.7 ±69.4min, 129.1 ± 61.8min, P 〉 0.05 ）, the drainage volume （114.29 ± 59.46ml, 125.56 ± 72. l ml, P 〉 0.05 ）, the duration of hospitalization after operation （6. 62±0.92d, 7.50±1.34d, P 〉 0.05）, the complication rates （13.6%,32.6%, P 〉 0.05） for two groups. Conclusion Adrenal tumors can be performed safely and effectively because of its less traumatic and quicker recovery, retroperitoneal laparoscopic surgery should be considered as the first choice for adrenal tumors.