保留肾上腺功能的腹腔镜双侧嗜铬细胞瘤切除术

Laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma

目的探讨保留肾上腺功能的腹腔镜双侧嗜铬细胞瘤切除术的手术适应证、疗效及可行性。方法回顾性分析2011年1月至2016年12月北京协和医院收治的9例双侧肾上腺嗜铬细胞瘤患者的临床资料，男7例，女2例，平均年龄40（22-58）岁。CT提示双侧肾上腺肿瘤。结果9例均行保留肾上腺功能的腹腔镜双侧嗜铬细胞瘤切除术。随访4个月-6年，中位随访时间3.2年。9例均存活，肾上腺功能正常，无需长期激素替代治疗。结论双侧嗜铬细胞瘤临床少见，治疗难度大，行保留肾上腺功能的腹腔镜双侧嗜铬细胞瘤切除术，既可完整切除双侧肾上腺肿瘤，又避免患者长期激素治疗，是安全有效的治疗方式。

Objective To investigate the operative indication, therapeutic effects and feasibility of laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma.MethodsThe clinical data of 9 cases of bilateral pheochromocytoma from Jan. 2011 to Dec. 2016 were retrospectively analyzed. The cases included 7 males and 2 females with a mean age of 40 years old, ranging from 22 to 58. CT showed all the 9 cases had bilateral adrenal tumors.ResultsAll patients accepted laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma. All survived and had been followed up for 4 months to 6 years （median 3.2 years） . All cases kept normal adrenal function and avoid long-term corticosteroid dependence.ConclusionsBilateral pheochromocytoma is rare and difficult to treat. Adrenal function protection under laparoscopic bilateral cortical-sparing adrenalectomy for pheochromocytoma is safe and effective for patients. This opertation can both completely resect bilateral adrenal tumors and avoid long-term corticosteroid dependence.