原发性醛固酮增多症的后腹腔镜治疗

Retroperitoneal Laparoscopic Operations in the Treatment of Primary Aldosteronism

目的:探讨腹膜后腹腔镜治疗原发性醛固酮增多症(primary aldosteronism,PHA)的应用。方法:2002年1月～2009年1月,我院对211例(男109例,女102例)PHA患者行腹膜后腹腔镜手术治疗,其中肾上腺醛固酮腺瘤(APA)113例,单侧肾上腺增生(UNAH)62例,特发性醛固酮增多症(IHA)36例。结果:211例手术均获得成功,无严重并发症发生,手术时间35～360(119.32±58.65)min,出血量10～200(52.85±49.41)ml,住院天数5～14天,术后随诊1～7(2.50±1.58)年,血压恢复正常73例,血压明显改善83例,55例患者术后仍存在高血压,总改善率为74%。结论:应用后腹腔镜治疗PHA安全、有效。

Objective：To evaluate the application of retroperitoneal laparoscopic surgery for primary aldosteronism. Methods：From January 2001 to January 2009,211 patients（102 women and 109 men） with a confirmed diagnosis of primary aldosteronism underwent retroperitoneal laparoscopic operation. Of the 211 cases, there were 113 cases with aldosteron-producing adenoma and 62 cases with unilateral adrenal hyperplasia,36 cases with idiopathic hyperaldosteronism. Results： Operations were successfully performed in all cases, no severe complications were observed. The operative time ranged from 35 to 360（119.32±58.65）min and the operative bleeding ranged from 10 to 200 （52.85±49.41）ml. The hospital length of stay was ranged from 5 to 14 day. Follow-up was available for up to 1 to 7 （2.50 ± 1.58）years in 211 patients, blood pressure returned to normal in 73 cases,blood pressure improved in 83 cases,55 cases continued high blood pressure. Total improvement rate is 74%. Conclusions：It is safe and effective to perform retroperitoneal laparoscopic surgery for primary aldosteronism.