腹腔镜与开放手术治疗肾上腺嗜铬细胞瘤的回顾性对比研究

A retrospective study comparing the laparoscopic and open surgery for the treatment of adrenal pheochromocytoma

目的比较分析腹腔镜与开放手术治疗肾上腺嗜络细胞瘤的临床疗效。方法回顾性分析河南能化集团义马煤业集团总医院在2010年5月至2013年5月收治的136例’肾上腺嗜铬细胞瘤患者的临床资料，其中68例行腹腔镜切除术，为腹腔镜组；68例行常规开放手术治疗，为开放手术组。比较分析两组的临床疗效。结果开放手术组术中收缩压震幅、切口长度、术中出血量及输血量、手术时间、血压剧烈波动率及心率波动、术后引流量、术后引流时间及住院时间等指标均显著高于腹腔镜组，两组比较差异有统计学意义（分别t=8．4064、29．0568、8．2443、13．2023、16．4012、21．1662、21．1662、9．4445、8．7785、6．5322、8．7544，P均〈0．01）；同时，两组患者的肿瘤最大直径、术后并发症发生率和复发率比较差异未见统计学意义（P〉0．05）。结论腹腔镜治疗肾上腺嗜铬细胞瘤疗效较好，具有术中创伤小、出血少、术后病率低、安全性较高等优点．值得在临床推广使用。

Objective To compare the clinicat efficacy of laparoscope and open operation on adrenal pheochromocytoma. Methods Clinical parameters were retrospectively analyzed in 136 patients with adrenal gland pheochromocytoma from May 2010 to May 2013 in our hospital. Sixty-eight cases in retroperitoneoscopic group were treated with laparoscopic excision, while other 68 cases in open group were cured with open surgery. Then the clinical curative effects of these two groups were compared. Results After treatment, the levels of intraoperative systolic breadth, length of incision, intraoperative blood loss, intraoperative blood transfusion volume, operative time, blood pressure fluctuations in the number of cases, the size of the fluctuation of heart rate, postoperative drainage, postoperative drainage time and postoperative hospitalization days in open group were significantly higher than those of laparo- seopic group i t = 8. 4064, 29. 0568, 8. 2443, 13. 2023, 16. 4012, 21. 1662, 21. 1662, 9. 4445, 8. 7785, 6. 5322, 8. 7544, each P 〈 0. 01 ）. Differences between the two groups were statistically signifi- cant. There was no significant difference in maximum tumor diameter, complication incidence, recur- rence rate between open group and laparoscopic group （ P 〉 0.05 ）. Conclusions Compared with open operation, laparoscopic are suggested for the treatment of adrenal pheochromocytoma, as it has the obvious advantage such as more significant effect, minimal trauma, less intraoperative blood loss, lower postoperative morbidity, so it is worthy to be popularized in clinics.