后腹腔镜下切除巨大肾上腺肿瘤的临床观察

Clinical experience of retroperitoneal laparoscopic surgery for the treatment of huge adrenal tumors

目的总结后腹腔镜下切除巨大肾上腺肿瘤(≥6cm)的临床经验。方法自2007年6月至2013年3月对32例巨大肾上腺肿瘤(直径≥6cm)的患者行后腹腔镜下切除术,回顾性分析其临床资料。结果患者均顺利完成手术。平均手术时间80min(45～110min),术中出血量平均80ml(30～180ml)。术后随访时间3～50个月,平均19.5个月,仅1例患者复发转移。结论后腹腔镜下切除巨大肾上腺肿瘤安全可行,肿瘤大小不是腹腔镜下切除巨大肾上腺肿瘤的决定因素。优先阻断肾上腺中央静脉可以有效地减少出血和功能性肿瘤术中突发症状。

Objective To describe and summarize the clinical experience with retroperitoneal laparoscopic adrenalectomy to huge adrenal tumors. Methods The clinical data of 32 cases with adrenal tumors ≥6cm in size who had a retroperitoneal laparoscopic adrenalectomy between Jun. 2007 and Mar. 2013 were reviewed retrospectively. Results All the operation were successful. The average operation time was 80min（ 45 to 110min）,the average intraoperative blood loss was 80ml（ 30 to 180ml）. The follow up for all cases ranged from 3 to 50 months（ average 19. 5 months）,1 patient died of recurrence. Conclusion Retroperitoneal laparoscopic adrenalectomy for huge adrenal tumor is technically feasible and safe. Tumor size was not the determinants of laparoscopic resection of adrenal tumor. Priority blocking adrenal central vein could effectively reduce intraoperative bleeding volume and sudden functional tumor symptoms.