后腹腔镜与开放行肾上腺嗜铬细胞瘤切除术的临床疗效比较

Comparison of clinical efficacy between retroperitoneal laparoscopic surgery and open adrenalectomy for adrenal pheochromocytoma

目的比较后腹腔镜与开放手术治疗肾上腺嗜铬细胞瘤的临床疗效。方法回顾分析该科41例肾上腺嗜铬细胞瘤切除术患者的临床资料,其中后腹腔镜手术组18例,开放手术组23例。比较两种手术方法的手术时间、术中失血量、术中血压剧烈波动例数(血压变化≥50 mmHg为剧烈波动)、术后引流管拔除时间、术后止痛药用量、术后住院时间的差别。结果 41例手术均获成功,两组患者的一般资料差异无统计学意义(P>0.05)。腹腔镜手术组在手术时间、术中出血量、术中血压剧烈波动例数、术后引流管拔除时间、术后止痛药用量、术后住院天数等方面优于开放手术组(P<0.05)。结论掌握合适的手术适用证及熟练的腹腔镜操作技术,后腹腔镜肾上腺嗜铬切除术治疗肾上腺嗜铬细胞瘤安全有效的。

Objective To compare clinical efficacy of retroperitoneal laparoscopic surgery and open surgery on the treatment of adrenal pheochromocytoma. Methods The clinical data of 41 patients with adrenal pheochromocytoma resection were analyzed retrospectively, of which 18 patients were retroperitoneal laparoscopic surgery group and 23 patients were open surgery group. The two surgical methods were compared in the patients＇ operation time, intraoperative blood loss, the cases of intraoperative sharp fluctuations in blood pressure （50 mmHg or higher blood pressure change of volatile） ,removal time of postoperative drainage tube,dosage of postoperative pain,postopera- tive length of hospital stay. Results 41 surgeries were successful. There was no statistically significant difference between patients in general information （ P 〉 0.05 ）. In the retroperitoneal laparoscopic surgery group, the operation time, intraoperative blood loss, cases with acute fluctuations of intraoperative blood pressure, removal time of postoperative drainage tube, dosage of postoperative pain, postoperative hospitalization days were better than those in the open adrenalectomy group （P 〈 0.05 ）. Conclusions With appropriate operation indi- cations of the disease and skilled laparoscopic operation technique, retroperitoneal laparoscopic adrenalectomy for the treatment of adrenal pheochromocytoma is safe and effective.