腹腔镜肾上腺切除术23例报告

Laparoscopic adrenalectomy (Report of 23 cases)

目的 :探讨腹腔镜在肾上腺手术中的应用。方法 :2 0 0 0年 2～ 11月对 2 3例肾上腺疾病患者施行腹腔镜肾上腺切除术 ,其中经腹腔途径 16例 ,经后腹腔途径 7例。结果 :除 1例中途改行开放手术后 ,余 2 2例均获得成功。手术时间 :经腹腔途径的 5 0～ 2 5 0 m in,平均 10 4min,经后腹腔途径者 6 5～ 130 m in,平均 95 m in。所有患者术中及术后均未输血 ,无明显并发症。结论 :腹腔镜肾上腺切除术具有损伤小、术后恢复快和住院时间短等优点 ,具有良好的临床应用前景。

Purpose:To investigate the clinical application of laparoscopic adrenalectomy and summarize the experience in laparoscopic adrenalectomy.Methods:From Feb.2000 to Nov.2000, 23 patients underwent laparoscopic adrenalectomy, among them 16 cases underwent transperitoneal approach, 7 cases underwent postperitoneal approach. Of the 23 cases, 5 were diagnosed as adrenal cortex hyperplasia, 2 adrenal cyst and 16 adrenal tumor including 5 pheochromocytoma, 10 adrenal adenoma (6 cases of primary aldosteronism, 2 cases of Cushing′s syndrome and 2 cases endocrinologically nonactive adenoma), 1 dermoid tumor.Results:Of the 23 cases, 22 underwent successful operation, but one case was subjected to the open surgery during operation. Operating time was between 50 and 250 min with an average of 140 min in transperitoneal group and between 65 and 130 min with an average of 95 min in postperitoneal group. All patients did not receive blood transfusion and had no obvious complications.Conclusions:Laparoscopic adrenalectomy has the advantages of minimal morbidity, minimal postoperative discomfort and a short hospital stay, which has a good applied future in the clinical practice.