后腹腔镜在肾上腺疾病手术治疗中临床应用（附123例报告）

A clinical analysis of retroperitoneal laparoscopic adrenalectomy in 123 patients

目的 评价后腹腔镜肾上腺病变手术的方法和临床应用价值.方法 对本院2002年12月～2008年7月收治的123例经后腹腔镜肾上腺病变手术进行回顾性分析.结果 所有患者手术均获成功,所有患者均于术后第1天下地活动,手术时间平均141（97～186）min,术中出血量平均73（34～112）ml,术后住院天数5（4～6）d,术后1例出现胰腺瘘,经保守治疗治愈.结论 后腹腔镜肾上腺手术具有损伤小、痛苦小、术中出血少、术后恢复快、住院天数少等优点,应成为肾上腺良性疾病的首选手术方法.66例随访半年,血钾均恢复正常,其中61例血压完全恢复正常,5例降压药的用量明显减少并容易控制.皮质腺未见复发及转移.失访57例.

Objectives To evaluate the clinical efficacy and method of retroperitoneal laparoscopic adrenalectomy. Methods 123 retroperitoneal endoscopic adrenalectomy were performed in our clinic for the period of December 2002 to July 2008. Results All the 123 treated by retroperitoneal laparoscopic ademalectomiy were underwent successfully. All patients exercised in the first day after postopertion, operative time ranged From97 to 186 min. Estimated intraoperative blood loss were about 34 to 112 ml, postopertion stay was about 4 to 6 days, 1 case occurred pancreas fistula postopertion, by keep treatment cure. Conclusions Our initial experience showed that retroperitoneal laparoscopic adrenalectomy was minimally invasive and safe surgical technique with short length of hospital stay and rapid recovery. and should be the first option for the treatment of benign adrenal diseases. Follow-up time ranged 6 mouths. No tumor recurrence and metastasis was noted in 66 cases. Follow-up of 66 cases showed that serum potassium levels of all patients were normal,61 cases blood pressu＇re recovery normal,5 patients with high blood pressure stillneed hypotensive drug.