机器人辅助腹腔镜肾上腺部分切除术治疗肾上腺肿瘤(附11例报道)

Robot-assisted laparoscopic partial adrenalectomy (report of 11 cases)

目的探讨机器人辅助腹腔镜肾上腺部分切除术治疗肾上腺肿瘤的可行性及疗效。方法回顾11例完成机器人辅助腹腔镜肾上腺部分切除术患者的临床资料,统计手术情况、术后并发症及随访情况。结果 11例患者中男6例、女5例,右侧5例、左侧6例,有高血压病史8例,其中2例合并低钾血症;手术均获得成功,平均手术时间111.36±31.39 min,平均失血量45±36.81 mL,平均住院时间5.45±1.36 d,术后无严重并发症发生。术后8例高血压患者血压均好转,2例低血钾患者血钾均恢复正常水平。术后病理:嗜铬细胞瘤1例,髓质脂肪瘤1例,其余9例均为肾上腺皮质腺瘤。术后3月随访复查CT,未见肿瘤复发。结论机器人辅助腹腔镜肾上腺部分切除术既保留部分肾上腺功能,又完整切除肿瘤,具有视野好,手术精准度高,手术疗效好的优点,是治疗肾上腺肿瘤安全有效的新方法。术后局部复发率低,但仍需长期随访数据。

Objective To explore the outcome and feasibility of robotic assisted laparoscopic partial adrenalectomy. Method 11 patients who underwent robotic assisted laparoscopic partial adrenalectomy were included and their clinical data was identified retrospectively and theses patients＇s operational status, post-operational complications and follow up records were run for statistical analysis. Findings 1 1 patients included male 6 cases, female 5 cases ;rlght side 5 cases,left side 6 cases. 8 of them have hypertension disease, 2 of which with hypokalemia. All robot-assisted laparoscopic process performed successfully. The mean operation time was 111. 36 ± 31. 39 min, estimated blood loss was 45 ±36. 81 mL, hospital discharge time was 5.45 ± 1.36 days. No severe complications. 8 patients with high blood pressure, the pressure was decreased after operation. 2 patients with hypokalemia recover to normal potassium level after surgery. Postoperativepathology were： 1 case pheochromocytoma, 1 case myelolipoma, and 9 cases adrenocortical adenoma. All of them finished three months follow-up after surgery and found no recurrence on CT. Conclusion In the treatment of adrenal tumors, robot- assisted laparoscopic partial adrenalectomy is a minimal invasive method not only resection the adrenal tumor but also preserve normal adrenal tissue, is a safe and effective new method. Local recurrence rates are low but still need longer follow up.