后腹腔镜肾上腺嗜铬细胞瘤切除术与开放手术的疗效比较

Comparison of clinical efficacy of retroperitoneal laparoscopic surgery and open adrenalectomy for adrenal pheochromocytoma

目的:评价后腹腔镜手术治疗肾上腺嗜铬细胞瘤的疗效。方法:对我院15例行单侧后腹腔镜肾上腺嗜铬细胞瘤手术(后腹腔镜组)和18例行单侧开放性肾上腺嗜铬细胞瘤手术(开放手术组)的患者的临床资料进行比较。结果:后腹腔镜手术组15例均手术成功;肿瘤直径最大2.1～8.5 cm,平均(4.2±1.8)cm;手术时间55～180 min,平均(85±35)min;出血量25～105 ml,平均(45±25)ml;术中2例发生高血压,术后止痛剂应用1次;术后下床活动时间为2～4 d,平均(2.5±1.5)d;术后住院时间为5～8 d,平均(6.0±1.5)d。开放手术组18例均手术成功;肿瘤直径最大2.0～10.5 cm,平均(4.5±2.5)cm;手术时间90～250 min,平均(140±50)min;出血量95～650 ml,平均(350±150)ml;输血6例,术中10例发生高血压,术后止痛剂应用4次;术后下床活动时间为5～7 d,平均(5.5±1.5)d;术后住院时间为7～12 d,平均(10.5±1.5)d。结论:对有较丰富腹腔镜手术经验的术者,后腹腔镜肾上腺嗜铬细胞瘤手术不仅手术时间短、出血量少、对患者的创伤小,而且术中对血压的控制较好,是治疗肾上腺嗜铬细胞瘤安全、有效的方法。

Objective： To investigate the clinical efficacy of retroperitoneal laparoscopic excision of adrenal pheochromocytoma. Methods： Retroperitoneal laparoscopie resection of adrenal pheochromocytoma was successfully performed on 15 patients （retroperitoneal laparoscopic group）. 18 cases with adrenal pheochromocytoma underwent open surgery （open surgery group）. The outcomes of the two groups were compared. Results： 15 cases of the laparoscopic surgery group were successfully performed, tumor maximum diameter was 2.1-8.5 cm, average （4.2±1.8） cm; operation time was 55-180 min, average （85±35） min; bleeding volume was 25-105 ml, average （45±25） ml; intraoperative hypertension occurred in 2 cases, postoperative analgesics were applied for one time; getting out of bed after operation was 2-4 d, average （2.5±1.5） d; post operative hospital stay was 5-8 d, average （6.0±1.5） d. 18 cases of open surgery group were successfully performed; tumor maxi mum diameter was 2.0-10.5 cm, average （4.5±2.5） cm; operation time was 90-250 min, average （140±50） min; bleeding vol ume was 95-650 ml, average （350±150） ml; blood transfusion in 6 cases, intraoperative hypertension occurred in 10 cases, postoperative analgesics were applied for 4 times; getting out of bed after operation was 5-7 d, average （5.5±1.5） d; postoperative hospital stay was 7-12 d, average （10.5±1.5） d. Conclusion： Based on the experience and skills of the surgeons, retroperitoneoscopic adrenaleetomy for pheochromocvtoma has advantages such as shorter operation time, less blood loss, minimal invasion, better intraoperative control of blood pressure and similar clinical efficacy with open surgery. It is therefore a safe and effective method in treating pheochromocytoma.