单切口多通道后腹腔镜肾上腺肿瘤切除术的可行性和安全性研究

Clinical experience of single-incision multiport retroperitoneal laparoscopic adrenalectomy

目的：探讨使用常规腹腔镜器械经后腹膜腔行单切口多通道肾上腺肿瘤切除术的可行性和安全性。方法：选取我院自2011年10月～2013年6月收治的。肾上腺肿瘤患者12例，男6例，女6例，年龄35～60岁，平均42．6岁。肿瘤最大径1．5～3．5cm，平均2．8cm。肿瘤位于右侧5例，左侧7例。在腋中线髂脊上3～4cm做直径长约3cm半圆形切口，应用常规腹腔镜器械行单切口多通道后腹腔镜肾上腺肿瘤切除术。结果：12例患者手术均获成功，无一例中转开放手术。手术时间90～120min，平均106min。出血量50～150ml，平均95ml。术后引流管留置时间1～3d。术后平均住院时间4～6d。所有患者术后未使用镇痛药物。术后病理检查报告为嗜铬细胞瘤3例，皮质腺瘤9例。结论：应用常规腹腔镜器械经后腹膜腔行单切口多通道肾上腺肿瘤切除术安全有效，不仅具有传统腹腔镜手术的优点，还可以减少手术费用及手术创伤，并具有一定美容效果。

Objective：To evaluate the feasibility and efficacy of single-incision multiport retroperitoneal laparo- scopic adrenaIeetomy by conventional laparoseopie instruments. Method：Twelve cases treated in our hospital from October 2011 to June 2013 received the surgery. There were six males and six females. The average age of pa- tients was 42.6 （range, 35-60） years. The average diameter of tumor was 2.8 （range, 1.5-3.5） cm. There were five patients with the tumor located in the right adrenal gland and seven patients with the tumor located in the left adrenal gland. A single 3 cm arch incision was situated in midaxillary line 3 to 4 cm above the iliac crest, and then multiport retroperitoneal laparoscopie adrenalectomies with conventional laparoseopic instruments were taken for all patients. Result.. All procedures were successful without conversion to open surgery. The average operative time was 106 （ranged, 90-120） min, and estimated average blood loss was 95 （range, 50-150） ml. The drainage time was 1-3 days and postoperative hospital stay was 4-6 days. All patients didn＇t take analgesic drug after operation. The results of pathological tests showed three cases were found pheochromocytoma and nine patients were diag- nosed of adrenocortieal adenoma. Conclusion：Single-incision multiport retroperitoneal laparoscopic adrenaIectomy with conventional laparoscopie instruments is a safe and effective therapeutic method for adrenal tumor. It has not only some advantages of traditional surgery but also less expense and trauma. Moreover, cosmetic results are sat- isfactory.