后腹腔镜切除较大肾上腺髓样脂肪瘤的疗效观察

Retroperitoneoscopic adrenalectomy for comparatively large adrenal myelolipoma

目的评价后腹腔镜较大肾上腺髓样脂肪瘤切除术的临床疗效。方法回顾分析我院采用后腹腔镜手术治疗直径在5 cm以上的15例(16侧)肾上腺髓样脂肪瘤患者的临床资料。结果患者手术均获成功,无术中及术后大出血及腹腔脏器损伤。平均手术时间为87.93 min(50~140 min),平均出血量为41.69 m L(25~70 m L),术后1~3 d进食,卧床3~6 d,平均引流管留置时间3.80 d(3~5 d),术后5~7 d出院。术后病理诊断均与术前诊断相同。术后平均随访6个月,肿瘤无一例复发。结论肾上腺髓样脂肪瘤周围界限清楚,即使肿瘤体积较大,也可应用后腹腔镜切除,且显露较开放手术更清晰,疗效安全可靠。

Objective To evaluate the clinical efficacy of retroperitoneoscopic adrenalectomy for comparatively large adrenal myelo-lipoma.Methods The clinical data of 15 cases(16 sides)of large adrenal myelolipoma of the past 5 years who underwent the retroperitoneal laparoscopic surgery were retrospectively analyzed.Results The operation was successful in all patients.No intraoperative and postoperative bleeding and injury of abdominal organs and vessels.The average operation time was 87.93 min(50 ~140 min);the mean blood loss was 41.69 mL(25 ~70 mL);after surgery,1 ~3 d eating,lying in the bed for 3 ~6 days,the average drainage tube indwelling time was 3.80 (3~5 d);patients were discharged 5 ~7 days after operation.Postoperative pathological diagnosis were the same as the preoperative diagno-sis.The mean follow -up time was 6 months,and no tumor recurrence was found.Conclusion Clear boundaries are around the adrenal my-elolipoma,and despite the large size of the tumor,retroperitoneoscopy can be performed,which is safe and effective,and which has clearer vi-sion than open surgery.