经腹腔途径腹腔镜解剖性肾上腺切除术的临床体会

The experiences of transperitoneal laparoscopic anatomical adrenalectomy

目的:总结经腹腔途径腹腔镜解剖性肾上腺切除术的手术体会及经验。方法:2008年10月至2013年3月采用经腹腔途径行腹腔镜解剖性肾上腺切除术56例,其中男34例,女22例,平均(45.1±11.2)岁。左侧37例,右侧19例,肿瘤直径平均(3.3±0.61)cm。结果:56例手术均经腹腔途径顺利完成,无中转开放,手术时间平均(67±16)min,估计术中出血平均(38±10.3)ml,术后平均(1.5±0.5)d肛门排气,术后24 h下床活动,术中、术后均未输血,且无严重并发症发生。术后病理证实为肾上腺腺瘤。结论:经腹腔途径行腹腔镜解剖性肾上腺切除术具有手术空间大、解剖标志清晰、手术创伤小、康复快等优点,是肾上腺切除术的安全术式。

Objective： To summarize the experiences of transperitoneal laparoscopic anatomical adrenalectomy. Methods： From Oct. 2008 to Mar. 2013,56 cases underwent transperitoneal laparoscopic anatomical adrenalectomy,including 34 males,22 females. The average age was（ 45. 1 ± 11. 2） years old. Neoplasms located at left adrenal gland in 37 cases,right in 19 cases. The average neoplasms diameter was（ 3. 3 ± 0. 61） cm. Results： The operations were successfully completed in 56 cases,no patients were converted to open surgery. Average operative time was（ 67 ± 16） min. Estimated average blood loss was（ 38 ± 10. 3） ml. Gastrointestinal fuction recovered in（ 1. 5 ± 0. 5） d postoperatively,average time to ambulation was 24 h after operation. No serious complications or blood transfusion occurred. All patients were pathologically diagnosed as adrenal neoplasms. Conclusions： The advantages of transperitoneal laparoscopic anatomical adrenalectomy include large working space,excellent view,clear anatomic marks,minimal invasion and quick recovery,which provides a safe method for adrenalectomy.