腹膜后腹腔镜肾上腺肿瘤切除术35例报告

Retroperitoneal laparoscopic adrenalectomy:with a report of 35 cases

目的：总结腹膜后腹腔镜手术治疗肾上腺肿瘤的临床经验。方法：回顾分析2003年5月至2008年12月我院行腹膜后腹腔镜手术治疗肾上腺肿瘤35例患者的临床资料。结果：33例腹腔镜手术成功,2例术中探查为胃肠道肿瘤,中转开放手术。手术时间40～275min,平均（136.2±62.3）min。术中出血20～200ml,平均（91.0±48.2）ml。术后住院5～7d,平均（6.2±0.8）d。发生腹膜损伤2例,瘤体破裂出血1例,Trocar穿刺口脂肪液化3例。结论：用腹腔镜行肾上腺肿瘤切除术具有患者创伤小、术中出血少、术后康复快等优点,但需根据肿瘤大小和病理类型严格掌握,同时应重视局部解剖关系。

Objective：To summarize our clinical experience on retroperitoneal laparoscopic adrenalectomy.Methods：From May 2003 to Dec.2008,35 cases with adrenal tumor received retroperitoneal laparoscopic adrenalectomy in our department,including 15 male cases and 20 female cases.Results：The overall successful rate of laparoscopic adrenalectomy was 94%（33/35）,2 cases were converted to open operation due to gastrointestinal tumor.The operation time was 40-275min,mean（136.2±62.3）min.The blood loss was 20-200ml,mean（91.0±48.2 ）ml. Postoperative hospitalization time was 5-7d ,mean （6.2 -±0. 8 ）d. 2 cases had peritoneal injury,1 case had tumor rupture and hemorrhage, and 3 eases had incision fat liquefaction. Conclusions： Laparoscopic resection of adrenal tumors has advantages of less trauma, less bleeding, faster postoperative recovery and so on, but indication should base on tumor size and pathologic type strictly,while local anatomy must be paid more attention.