腹膜后腹腔镜与开放手术治疗肾上腺疾病的对比分析

Comparison and analysis of treatment of adrenal diseases by retroperitoneal laparoscopy and open surgery

目的:比较腹膜后腹腔镜与开放手术治疗肾上腺疾病的临床特点,总结应用腹膜后腹腔镜技术治疗肾上腺疾病的临床经验。方法:回顾分析2007年9月至2009年10月治疗46例肾上腺疾病患者的临床资料,其中26例行腹膜后腹腔镜手术,20例行开放性手术,对比两组的手术时间、术中出血量、术后肠功能恢复时间、术后住院时间等指标。结果:46例均顺利完成手术。腹膜后腹腔镜组1例胸膜损伤,用合成夹妥善处理;开放组2例切口感染,经积极治疗后痊愈,余均未发生严重并发症;腹膜后腹腔镜组术中出血量、术后肠功能恢复时间及术后住院时间均优于开放手术。结论:腹膜后腹腔镜技术治疗肾上腺疾病具有患者创伤小、出血少、康复快、术后住院时间短等优点,随着手术技术的不断成熟,手术时间会短于开放组,并可成为治疗肾上腺疾病的理想术式。

Objective：To compare the clinical characteristics of retroperitoneal laparoscopy and open surgery in treatment of adrenal diseases,sum up clinical experience of retroperitoneal laparoscopic surgery.Methods：The clinical data 76 cases with adrenal disease from Sep.2007.9 to Oct.2009 were retrospectively analyzed,retroperitoneal laparoscopic surgery was carried out in 26 cases,and open surgery was carried out in the other 20 cases.The two groups were compared in operative time,blood loss,postoperative bowel function recovery time and postoperative hospital stay respectively.Results：The operation of the two groups was successful.Effect of two different surgical methods was the same.In the retroperitoneal laparoscopic group,pleural injury occurred in 1 case and treated by synthesis clip.In the open group,wound infection occurred in 2 cases and recovered after the active treatment,the others did not appear serious complications.Retroperitoneal laparoscopic group was significantly less than open group in blood loss,postoperative bowel function recovery time and postoperative hospital stay.Conclusions：Retroperitoneal laparoscopic technology is suggested in the treatment of adrenal diseases for its less damage,less blood loss,quicker recovery,and shorter postoperative hospital stay.With ongoing training and constantly updating technical skills and equipments,the operative time will be shorter than open surgery.Retroperitoneal laparoscopic technology will replace open surgery as the best surgical procedure for adrenal diseases.