侧腹入路在腹腔镜肾上腺切除术中的应用

Trans-flank approach for laparoscopic adrenalectomy

目的:研究侧腹入路用于腹腔镜肾上腺切除术的疗效及安全性。方法:回顾分析2008年7月至2011年6月为15例患者经侧腹入路行腹腔镜肾上腺切除术的临床资料。结果:15例手术均获成功,主动侧腹入路手术时间平均(60±25)min,术中出血量平均(50±12)ml;被动侧腹入路手术时间平均(70±22)min,术中出血量平均(55±20)ml。术中未发生大出血和周围脏器损伤等严重并发症,无一例输血。术后24 h患者下床活动,术后平均住院3 d。结论:侧腹入路结合了经腹入路和后腹入路的优点,是腹腔镜肾上腺切除术的有效入路之一。后腹入路手术损伤腹膜时可及时切开腹膜中转为侧腹入路。

Objective ： To evaluate the efficacy and safety of trans-flank approach tot laparoscopic adrenalectomy. Methods ： The clinical data of 15 patients who underwent laparoscopic adrenalectomy traMs-flank peritoneal approach from Jul. 2008 to Jun. 2011 in our department were retrospectively analyzed. Results： All operations were successfully performed. The mean operative time of initiative group was （60 ±25） rain,and blood loss was （50 ± 12） ml. The mean operative time of passive group was （70 ± 22） rain,and blood loss was （55 ± 20） ml. There were no serious complications or blood transfusion. The average time to ambulation was 24 hours, and mean postoperative hospital stay was 3 days. Conclusions：The trans-flank approach integrates merits of transperitoneal approach and retropcritoneal approach, and it is an effective approach for laparoscopic adrenalectomy. When peritoneum is injured in retroperitoneal laparoscopic surgery,it is a good choice to open peritoneum and convert to passive trans-flank approach.