开腹与后腹腔镜术式治疗肾上腺良性肿瘤的比较

Comparison of open and retroperitoneal laparoscopic adrenalectomy in the treatment of benign adrenal tumors

目的探讨开腹与后腹腔镜术式对肾上腺良性肿瘤患者围手术期临床指标、ICU转送率及并发症的影响。方法选取120例肾上腺良性肿瘤患者为研究对象,以随机数字表法分为对照组和观察组,每组各60例;其中对照组患者采用开腹术式治疗,观察组患者则采用后腹腔镜术式治疗;比较两组患者的手术时间、术中失血量、肛门排气时间、术后引流量、术后拔管时间、住院时间、ICU转送率及并发症发生率。结果观察组患者手术时间、肛门排气时间、术后拔管时间及住院时间均显著短于对照组(P<0.05);观察组患者术中失血量和术后引流量均显著少于对照组(P<0.05);两组患者ICU转送率比较差异无统计学意义(P>0.05);同时观察组患者术中和术后并发症发生率均显著低于对照组(P<0.05)。结论后腹腔镜术式治疗肾上腺良性肿瘤可有效减轻医源性损伤程度,促进术后早期康复,且有助于避免术中及术后出现并发症,其临床应用价值优于开腹术式。

Objective To investigate the influence of two kinds of surgical scheme including open surgery and retroperitoneal laparoscopy surgery on perioperative clinical index, ICU transfer rate and complications of patients with benign adrenal tumor. Methods 120 patients with benign adrenal tumors were chosen and randomly divided into both group including control group （60 patients） with open surgery and observation group （60 patients） with retroperitoneal laparoscopy surgery; and the operation time, intraoperative blood loss amount, anal exhaust time, postoperative drainage volume, extubation time, hospitalization time, the ICU transfer rate and the complications incidence of both groups were compared. Results The operation time, anal exhaust time, extubation time and hospi- talization time of observation group were significantly shorter than those of control group （ P 〈 0. 05 ）. The intraoperative blood loss amount and postoperative drainage volume of observation group were significantly lower than those of control group （P〈0.05）. There was no significant difference in the ICU transfer rate between two groups（ P〉0. 05）. The complications incidence in operation and after operation of observation group were significantly lower than those of control group （P〈0. 05）. Conclusion Compared with open surger- y, retroperitoneal laparoscopy surgery in the treatment of patients with benign adrenal tumors can efficiently reduce the iatrogenic injury degree, promote postoperative rehabilitation at early stage and be helpful to avoid the complications in operation and after operation.