经腹腔和腹膜后途径腹腔镜手术治疗巨大肾上腺肿瘤的疗效分析

Analysis of the therapeutic effects of transabdominal and retroperitoneal laparoscopic treatment of large adrenal tumors

目的：比较经腹腔途径和腹膜后途径行腹腔镜手术治疗巨大肾上腺肿瘤的临床效果。方法：回顾分析2006-2009年收治的直径大于5 cm的肾上腺肿瘤患者的临床资料,24例经腹腔途径,14例经腹膜后途径。对比两组手术时间、术中出血量、术后进食时间、术后拔除引流管时间、并发症发生率、术后住院时间等指标。结果：腹膜后腹腔镜组术中出血量、术后进食时间、术后拔除引流管时间、术后住院时间优于经腹腔途径（P〈0.05）,两组手术时间、并发症发生率差异无统计学意义（P〉0.05）。结论：在技术娴熟的条件下,腹膜后腹腔镜手术切除较大肾上腺肿瘤安全且患者损伤小、康复快。

Objective：To compare the therapeutic effects of transabdominal and retroperitoneal laparoscopic operation in treatment of large adrenal tumors.Methods：Retrospective analysis was made on the clinical data of 38 patients with adrenal tumors greater than 5cm in diameter from 2006 to 2009,among them,24 cases underwent transabdominal laparoscopic surgery and others with retroperitoneal laparoscopy.Operative time,intraoperative bleeding,the eating time after operation,time of removing drainage tube,hospital stay,the complication rate and so on were compared.Results：The retroperitoneal laparoscopic group was better than transabdominal group in the intraoperative blood loss,the eating time after operation,time of removing drainage tube and hospital stay（P0.05）,but there was no statistically significant difference on operative time and the complication rate（P0.05）.Conclusions：In the premise of skilled technique,the retroperitoneal laparoscopic resection of large adrenal tumors is safe,mini-invasive and of rapid recovery.