无症状肾上腺嗜铬细胞瘤23例的临床分析

Treatment of asymptomatic surrenal pheochromocytoma in 23 cases

目的探讨肾上腺来源的无症状嗜铬细胞瘤的诊治经验。方法回顾性分析肾上腺来源的无症状性嗜铬细胞瘤23例,讨论其诊断、术前准备、手术方式与围手术期注意要点。结果18例顺利切除肿瘤,其中腹腔镜切除11例,开放手术切除7例,术中出现血压升高14例。5例诊断腹膜后包块于本院外科治疗,其中4例术中血压控制后行开放肾上腺切除术,1例血压升高到240mm Hg/160mm Hg无法控制,面色苍白,立即中止手术,关腹后扩容降压治疗4d、再次开放手术治疗切除肿瘤。切除肿瘤最大12.0cm×8.5cm×6.5cm,最小1.1cm×0.7cm×0.5cm。结论对无症状性嗜铬细胞瘤,尤其肿瘤较小的更应引起重视,充分的术前准备是手术成功和患者顺利恢复的关键。

Objective To summarize and analyse the treatment experience of 23 cases of asymptomatic surrenal pheoehromocytoma. Methods The diagnosis,preparation before operation,the modus operandi,and the main points after or before operation were retrospectively summarized. Results Eighteen cases of tumor excision were successfully performed,including 11 cases with the laparoscope and 7 cases with the open surgery excision,during the operation the blood pressure was elevated in 14 cases. Five cases were treated in general surgery because of retroperitoneal phyma. The biggest tumor was 12.0cm × 8.5cm × 6.5cm, the smallest tumor was 1. 1cm × 0. 7cm × 0. 5cm. Conclusion We must think highly of asymptomatic surrenal pheochromocytoma, especially small tumor. The key point of successful operation is sufficient preparation.