肾上腺嗜铬细胞瘤腹腔镜手术的安全性评价

Safety Evaluation of Laparoscopic Surgery for Adrenal Pheochromocytomy

目的:评价后腹腔镜行肾上腺嗜铬细胞瘤切除术的安全性。方法:对肾上腺嗜铬细胞瘤后腹腔镜切除术9例(A组),腹膜后开放手术15例(B组)的临床资料进行回顾分析,对手术时间、术中出血量、术中输血率、术后肠道恢复时间、术后住院时间、术中、术后并发症以及手中各时点的血压、心率情况和术中血流动力学不稳定事件的发生率进行对比并做统计学分析。结果:A组手术时间长于B组,差异有统计学意义(P<0·05)。两组间出血量、输血率、术后肠道恢复时间、总并发症率、术中及术后并发症率差异没有统计学意义(P>0·05)。A组术后住院时间短于B组,差异有统计学意义(P<0·05)。两组收缩压、舒张压、心率在术中各时间点的差异均没有统计学意义(P>0·05)。两组间在心动过速、低血压及血流动力学不稳定事件发生率方面的组间差异均也没有统计学意义(P>0·05)。结论:后腹腔镜肾上腺切除可缩短术后住院时间,不增加并发症发生率,并且术中对患者的血流动力学影响与开放手术相当。手术适应症选择适当,后腹腔镜肾上腺嗜铬细胞瘤切除术与开放手术具有同样的安全性。

Objective：To investigate retrospectively the safety of retroperitoneal laparoscopic excision of pheochromocytoma.Methods：Retroperitoneal laparoscopic excision of pheochromocytoma was performed on 9 patients（group A）.At the same period,15 patients with pheoehromoeytoma undergoing retroperitoneal open surgery served as the controls（group B）.Operative time,estimated blood loss,transfusion rate,mean duration of gastrointestinal tract recovery,average postoperative hospital stay,intraoperative and postoperative complications,and the hemodynamics parameters were compared between the 2 groups.Results：The mean operative time of group A was longer than that of the group B（P〈0.05）.The differences of estimated blood loss,transfusion rate,mean duration of gastrointestinal tract recovery,intraoperative and postoperative complications between the 2 groups were not statistically significant（P〉0.05）.The average postoperative hospital stay of group A was shorter than that of the group B（P〈0.05）.The differences of hemodynamics parameters between 2 groups was not statistically significant（P〉0.05）.Conclusion：Retroperitoneal laparoscopic excision of pheochromocytoma could shorten the average postoperative hospital stay and the numbers intraoperative and postoperative complications were not increased.The two surgical methods had the same hemodynamic effects.In properly selected patients,retroperitoneal laparoscopic excision of pheochromocytoma was safe as the open surgery.