机器人腹腔镜术治疗嗜铬细胞瘤及合并巨大瘤栓的副神经节瘤3例报告

Robot-assisted laparoscopy for treatment of pheochromocytoma and paraganglioma with giant thrombus(Report of three cases)

目的：评价机器人腹腔镜术治疗嗜铬细胞瘤及合并巨大瘤栓的副神经节瘤的可行性及安全性。方法：回顾性分析2012年6月-2015年10月间所行2例机器人腹腔镜肾上腺嗜铬细胞瘤切除术和1例机器人腹腔镜合并巨大瘤栓的副神经节瘤切除术患者的临床资料：所有患者均有高儿茶酚胺血症的典型临床表现,通过内分泌、核医学和影像学检查定性定位。手术体位均采取侧卧位经腹途径。记录患者一般资料、肿瘤大小、瘤栓长度、手术时间（operating time,OT）、术中失血量（estimated blood loss,EBL）、术后住院天数（hospital stay,HS）及围手术期内分泌指标变化情况,分析手术效果。结果：所有患者手术均获得成功,平均肿瘤直径、瘤栓长度、OT、EBL、HS分别为51mm、100mm、140min、150ml、8.5d,术前患者24h尿去甲肾上腺素均显著升高,术后3、6个月复查各项指标均恢复正常。结论：机器人腹腔镜手术治疗嗜铬细胞瘤及合并巨大瘤栓的副神经节瘤是安全可行的。

Objective：To evaluate the feasibility and safety of robot-assisted laparoscopy for treatment of pheochromocytoma and paraganglioma with giant thrombus.Method：Clinical data of two cases of pheochromocytoma and one case of paraganglioma with giant thrombus from Jun 2012 to Oct 2015 were analyzed.All patients with typical clinical symptoms were diagnosed by endocrinology,nuclear medicine and radiology.The operations were performed by transperitoneal approach in lateral position.The demography,clinical data of patients,diameter of tumor,length of tumor thrombus,operating time（OT）,estimated blood loss（EBL）,postoperative hospital stay（HS）and endocrine changes were documented.Result：All operations were successfully performed.The average tumor diameter,length of tumor thrombus,OT,EBL,HS were 51 mm,100mm,140 min,150ml and 8.5drespectively.The level of 24h-urinary norepinephrine returned to normal range after operation in follow-up period of three and six months.Conclusion：The procedure of robot-assisted laparoscopy for treatment of pheochromocytoma and paraganglioma with giant thrombus is safe and feasible.