腹腔手术史患者行经腹腔入路腹腔镜肾上腺切除的可行性分析

Subsequent laparoscopic transperitoneal adrenalectomy for patients with previously undergoing abdo-minal surgeries

目的探讨既往腹腔手术史患者行经腹腔入路腹腔镜肾上腺切除的安全性及可行性。方法选取本院2010年1月至2014年12月行经腹腔入路腹腔镜肾上腺切除患者61例为研究对象,将其分为A组(既往有腹腔手术史,26例)与B组(无腹腔手术史,35例)。分析两组患者住院时间、手术时间、术中出血量、术中及术后并发症发生率。结果两组患者术中平均出血量及住院时间比较差异均无显著性(P>0.05)。A组患者平均手术时间长于B组(P<0.05)。两组患者术中及术后并发症发生率比较差异均无显著性(P>0.05),且均无明显远期并发症。结论腹腔手术史并不是腹腔镜肾上腺手术的禁忌证,在选择合适的病例、熟练掌握经腹腔入路解剖及腹腔镜技术的情况下,行经腹腔入路腹腔镜肾上腺切除术是可行且安全的。

Objective To analyze the effects of previous abdominal surgery on surgical outcomes in adrenal tumor patients subjected to laparoscopic adrenalectomy. Method The data included 61 patients operated by means of laparoscopic transperitoneal adrenalectomy from January 2010 to December 2014 were analyzed: previously subjected to at least one abdominal surgery(group A, n = 26), with no history of previous abdominal operations(group B, n = 35). Analyzed of the two groups of patients hospital stay, operative time, blood loss, intraoperative and postoperative complication rate. Result There was no significant difference in the average blood loss and hospitalization time between the two groups(P > 0.05). The mean operation time was longer in group A than group B(P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P > 0.05), and no significant long-term complications were found. Conclusion The previous abdominal surgery does not constitute a contraindication to laparoscopic transperitoneal adrenalectomy. It is feasible and safety under the appropriate patients selected and surgeon with experienced skill.