后腹腔镜手术治疗肾上腺嗜铬细胞瘤(附8例报告)

Retroperitoneal laparoscopic surgery for adrenal pheochromocytoma (8 cases)

目的探讨后腹腔镜手术治疗肾上腺嗜铬细胞瘤的疗效和安全性。方法回顾性分析了该院2004年10月～2008年5月后腹腔镜手术治疗8例肾上腺嗜铬细胞瘤患者的临床资料。结果8例手术全部成功,无中转开放手术。手术时间30～150min(平均55min),术中出血量40～120mL(平均60mL),均未输血,瘤体直径2.5～7.5cm(平均4.5cm),术后住院时间5～10d(平均7d)。病理检查报告均为嗜铬细胞瘤。随访3个月～4年,患者血压均恢复正常,无需服用降压药物,肿瘤局部无复发。结论后腹腔镜肾上腺嗜铬细胞瘤切除术损伤小、手术时间短、出血少,术后恢复快,临床应用前景广泛。直径超过6cm的肿瘤也可以被经验丰富的外科医生顺利切除。

ObjectiveTo evaluate the safety and effectiveness of retroperitoneal laparoscopic surgery for adrenal pheochromocytoma. MethodsClinical records of 8 cases of retroperitoneal laparoscopic resection of adrenal pheochromocytoma were reviewed from October 2004 to May 2008. ResultsAll operations were successful. No cases required conversion to an open approach. The operation time was 30～150 minutes （mean 55 minutes）. The in-traoperative blood lose was 40～120 mL （mean 60 mL）. Blood transfusion was required in no cases. The diameter of the excised masses was 2.5～7.5 cm （mean 4.5 cm）. The postoperative length of hospitalization was 5～10 days （mean 7 days）. The diagnosis was confirmed by pathologic studies. All cases were benign pheochromocytoma. During the follow-up period of three months to four years, 8 patients recovered normal blood pressure without antihypertensive drugs. No tumor recurrences developed. ConclusionsRetroperitoneal laparoscopic surgery for adrenal pheochro-mocytoma is safe and effective which offers advantages of minimal invasion, short operation time, less blood loss, quicker postoperative recovery, having a great future. For experienced surgeons, the tumors larger than 6 cm in di-ameter can also be removed using the retroperitoneal endoscopic approach.