开放与后腹腔镜手术治疗肾上腺良性肿瘤的前瞻性研究

Comparison between open surgery and retroperitoneal laparoscopy in the treatment of benign adrenal tumors

目的：探讨传统开放术式与微创后腹腔镜术式治疗肾上腺良性肿瘤近远期疗效及安全性的差异。方法：研究对象选取我院2012年1月~2015年5月收治肾上腺良性肿瘤患者共130例,采用随机区组法分为开放组（65例）和微创组（65例）,分别采用传统开放术式与微创后腹腔镜术式治疗;比较两组患者围手术期临床指标、症状改善率及围手术期并发症发生率等。结果：微创组患者手术时间、术中出血量、术后首次排气时间、术后引流量、术后拔管时间及住院时间均显著优于开放组,差异有统计学意义（P〈0.05）;两组患者ICU转入率比较差异无统计学意义（P〉0.05）;两组患者症状改善率比较差异无统计学意义（P〉0.05）;微创组患者围手术期并发症发生率均显著低于开放组,差异有统计学意义（P〈0.05）。结论：相较于传统开放术式,微创后腹腔镜术式治疗肾上腺良性肿瘤可有效减轻术中创伤程度,加快术后康复进程,并有助于降低围手术期并发症发生风险。

Objective：To compare the clinical effects and safety between traditional open operation and minimally invasive retroperitoneal laparoscopy in the treatment of benign adrenal tumors.Method：From January 2012 to May 2015,130 patients with benign adrenal tumors were chosen in our hospital and randomly divided into open group（65patients）treated with traditional open operation and minimally invasive group（65patients）treated with retroperitoneal laparoscopy.We recorded perioperative clinical data,the symptom improvement rate and perioperative complications of both groups,and compared the data between two groups.Result：The operation time,intraoperative blood loss,the first exhaust time after opeartion,postoperative drainage volume after opeartion,postoperative extubation time and hospitalization time of minimally invasive group were significantly superior to those of open group（P〈0.05）.Also,the incidence of perioperative complications of minimally invasive group was significantly lower than that of open group（P〈0.05）.However,there was no significant difference in the ICU transfer rate between two groups（P〉0.05）.Moreover,there was no significant difference in the symptom improvement rate between two groups（P〉0.05）.Conclusion：Compared with traditional open operation,minimally invasive retroperitoneal laparoscopy in the treatment of benign adrenal tumors can efficiently reduce the trauma degree in operation,accelerate the rehabilitation process after operation and be helpful to reduce the risk of perioperative complications.