两种途径腹腔镜肾上腺肿瘤切除术228例临床效果比较

Comparison of 228 cases' clinical effects in laparoscopic adrenectomy via two approaches

目的探讨经脐单孔腹腔镜手术途径(E-NOTES)与经后腹腔手术途径腹腔镜肾上腺肿瘤切除术的临床效果。方法对该科在2009年6月～2011年10月施行腹腔镜肾上腺肿瘤切除术228例患者的临床资料进行回顾性分析。结果经脐单孔腹腔镜途径35例,,经后腹腔镜途径193例,全部手术均获成功;除1例患者术后5个月死于原发病外,其余患者血压控制平稳,血浆激素水平等指标恢复正常,复查CT等未发现明显肿瘤复发征象。与经后腹腔手术途径相比,E-NOTES除手术时间稍长外,在住院天数、术后发热及并发症等方面可达到同样的效果。结论 E-NOTES安全、有效,长期临床效果可待进一步研究和证实。

[Objective] To investigate the clinical results of the two procedures of laparoscopic adrenalectomy in embryonic natural orifice transluminal endoscopic surgery（E-NOTES） and retroperitoneal surgery.[Methods] From June 2009 to October 2011,the clinical data of 228 cases received laparoscopic adrenalectomy were analyzed retrospectively.[Results] Except for 1 case died of the original disease after 5 months,other operations were successfully performed.The rest patients were in stable blood pressure control,plasmatic hormone levels and other indicators returned to normal,and did not find obvious signs of tumor recurrence after CT inspection.E-NOTES had the same effect in the hospital days,postoperative pyrexia and complications,while the operative time is a little longer than retroperitoneal surgery.[Conclusion] E-NOTES is safe and effective,however the long-term clinical effect should be further researched and confirmed.