后腹腔镜肾上腺肿瘤切除术35例临床应用体会

Retroperitoneal laparoscopic adrenalectomy in 35 cases

目的：探讨后腹腔镜肾上腺肿瘤切除术的临床应用价值。方法：经后腹腔途径行肾上腺肿瘤切除术35例。其中醛固酮腺瘤15例,皮质腺瘤9例,嗜铬细胞腺瘤6例,无功能腺瘤5例。术前均经B超、CT或MRI检查证实为肾上腺占位性病变。结果：35例均顺利完成手术,无严重并发症发生。手术时间50~160 min,术中出血40~300 ml。切除肿瘤直径1~6.5 cm。术后住院5~7天;出院后随访3~26个月,32例术后3个月内血压恢复正常,3例仍需服用降压药物。结论：后腹腔镜肾上腺肿瘤切除术具有创伤小、术中出血少、术后恢复快等优点,是治疗肾上腺良性肿瘤的首选方法,但需要根据肿瘤病理类型和体积大小严格掌握适应证。

Objective：To evaluate the clinical value of retroperitoneal laparoscopic adrenalectomy for benign adrenal tumors.Methods：Retroperitoneal laparoscopic adrenalectomy was conducted in 35 cases of adrenal tumor.The cases included 15 aldosterone-producing adenomas,9 Cushing′s syndromes,6 pheochromocytomas and 5 nonfunctional adrenal adenomas.B ultrasound and CT/MRI were used to diagnose all patients preoperatively.Results：All operations were completed successfully without any severe complications.The time of the operations was 50-160 min.The blood loss was 40-300 ml.The diameter of tumor was 1-6.5 cm.The postoperative hospital stay was 5-7 days.The patients were followed up for 3 to 26 months.Normal blood pressure was achieved in 32 patients in 3 months after operation and oral antihypertensive drugs were still needed in other 3 patients.Conclusions：Retroperitoneal laparoscopic adrenalectomy should be considered as the first choice for treatment of benign adrenal diseases with the advantages of less trauma,less blood loss and faster postoperative recovery.Indications should base on the pathologic type and tumor size strictly.