后腹腔镜手术治疗较大肾上腺嗜铬细胞瘤疗效观察(附5例报告)

Retroperitoneoscopic adrenalectomy for comparatively large pheochromocytoma:report of 5 cases

目的：探讨后腹腔镜手术治疗较大肾上腺嗜铬细胞瘤的有效性及安全性。方法：回顾性分析2011年12月～2013年1月收治的5例直径在6cm以上的肾上腺嗜铬细胞瘤患者临床资料：男2例，女3例，年龄20～62岁。左侧2例，右侧3例。有高血压、心悸、头痛、出汗等症状。肿瘤大小6．1～7．5cm，平均（6．8±0．6）cm。合并肾功能不全l例。结果：5例患者均成功施行后腹腔镜手术，手术时间90～185min，平均（130±45）min；术巾出血量50～350ml，平均（70±38）ml。术后5～7天出院。术后无严重并发症发生。1例术前肾功能不全患者术后疵压仍偏高。术后随访3～15个月，无局部复发及远处转移。肾功能不全患者血压用单药控制良好，余4例血压正常。结论：经充分术前准备及正确术中处理，采用后腹腔镜肾上腺切除术治疗较大肾上腺嗜铬细胞瘤是安全有效的。

Objective：To evaluate the efficacy and safety of retroperitoneoscopic adrenalectomy for treatment of comparatively large pheochromocytoma. Methods： From December 2011 to January 2013, 5 patients with pbeochro- mocytoma of diameter above 6 cm underwent retroperitoneoscopic adrenalectomy. This group included 2 men and 3 women with years between 20 and 62. Two tumors were on the left,and three on the right. These patients mainly presented hypertension with different complaints of palpitation, headache, sweating, etc. The mean tumor size was （6.8＋0.6） cm in diameter （range 6.1 to 7.5 ern）. One patient eoincidenced renal insufficiency. Results：The operations were successfully completed in all 5 cases. Mean operating time was （130±45） rain （range 90 to185）. Mean estimated bloodloss was （70±38） ml （range50 to 350）. Hospital stay after operation was 5-7 days. There were no serious intraoperative and postoperative complications occurred. One patient with preoperative renal insuf- ficiency still remained high blood pressure postoperatively. Follow-up for 3-15 months in the 5 cases found no local recurrence and metastasis. One patient with preoperative renal insufficiency used only one kind of hypotensive drug with satisfying result. The others had normal blood pressure. Conclusions： Retroperitoneoscopic adrenalectomy for comparatively large pheochromocytoma could be a safe and minimally invasive procedure with adequate preopera rive preparations and correct intraoperative manipulation.