后腹腔镜肾上腺切除术(附193例报告)

Retroperitoneal Laparoscopic Adrenalectomy report of 193 cases

目的总结后腹腔镜肾上腺切除术的手术治疗经验。方法本组193例术前均经超声、CT或CT动脉造影(CTA)等证实为肾上腺占位性病变。男70例,女123例,年龄12～74岁。右侧77例,左侧106例,双侧10例。193例患者均接受后腹腔镜肾上腺切除术。结果4例因出血中转开放手术,其余均在腹腔镜下完成手术。平均手术时间(92±12)min,出血量(56±10)ml,术后住院天数(7.3±0.8)d。肿瘤最大径0.5～7.5cm,平均3.25cm。术后无并发症发生。随访1～24个月,2例死于肿瘤恶化。结论后腹腔镜肾上腺切除术对最大径<8cm的肾上腺肿瘤安全、有效,创伤小、出血少、术后恢复快。

Objective To present our experiences of 193 cases retroperitoneal laparoscopic adrenalectomy （RLA）. Methods 193 patients were diagnosed of occupation of adrenal gland by ultrasound, CT or CTA who underwent surgery of RLA from September 2005 to December 2007.. There were 72 males and 123 females （12-74 years）. The tumors were on the fight side in 77 cases, on the left side in 106 cases and on both sides in the other 10 cases. Results 189 cases were performed successfully, and 4 cases were converted to open surgery due to hemorrhage. The average operative time was （92±12） min. The average intraoperative blood loss was （56±10） mL. The average postoperative stay was （7.3±0.8） d. The maximum tumor diameter was 7.5 cm, the minimal was 0.5 cm, and the average was 3.25 cna. The postoperative course was uneventfully. 2 patients died of corruption of tumor with a follow-up of 1 -24 months. Conclusiom RLA is a safe and effective procedure with less invasion and blood loss, a short convalescence in some adrenal tumors whose maximum diameters are less than 8 cm.