后腹腔镜下肾上腺肿瘤切除51例报告

Laparoscopie treatment for adrenal tumor:clinical report of 51 cases

目的:总结后腹腔镜下肾上腺肿瘤切除的临床经验,评估后腹腔镜治疗肾上腺肿瘤的安全性、有效性及手术适应证。方法:回顾分析后腹腔镜技术下行肾上腺肿瘤切除51例,其中肾上腺皮质腺瘤24例,嗜铬细胞瘤16例,肾上腺皮质增生3例,肾上腺囊肿2例,肾上腺髓性脂肪瘤3例,神经鞘瘤1例,肾上腺皮质癌1例,肾上腺血肿1例。其中肾上腺腺瘤直径大小为1.2-5.5cm。嗜铬细胞瘤直径大小约为3.3-9.8cm。结果:49例患者手术均在后腹腔镜下顺利完成。2例因出血中转为开放。手术时间70-240min。术中出血量30-300ml,均未输血。术后2-4天患者恢复肠蠕动后进食,平均住院时间为5-10天。结论:后腹腔镜下切除肾上腺肿瘤具有出血少、恢复快的优点,充分的术前准备及娴熟的镜下操作技术、扎实的镜下解剖基础是手术成功的关键,较大肿瘤不应成为手术禁忌症。

Objective：To summarize the experience of retroperitoneal laparoscopie treatment for adrenal tumors.Methods：Retroperitoneal laparoscopie technique was used in the adrenal tumor resection in 51 cases,including adrenal adenomas 24 cases,16 cases of pheochromocytoma,3 cases of adrenal medullary lipoma,2 cases of adrenal cysts,3 case of adrenocorticohyperplasia,1 schwannoma,1 adrenocortical carcinoma,adrenal hematoma in 1 case.Adrenal adenoma diameter size 1.2-5.5cm,pheochromocytoma were 3.3-9.8cm in diameter,average diameter was 4.5 ±3.5cm.Results：All 49 patients were successfully completed in retroperitoneal laparoscopic operation,2 cases because of bleeding was converted to open operation.The operation time was 70-240min,blood loss 30-300ml.Postoperative hospital stay was 5-10days,average 6.5 days,postoperative recovery was smooth,no significant postoperative complications.Conclusion：Laparoscopic treatment of adrenal tumors is a safe,reliable surgical method of adrenal gland with less bleeding,less trauma,faster postoperative recovery.Larger tumor should not become an operation ontraindications.