日间手术模式下后腹腔镜手术治疗肾上腺良性肿瘤的初步体会

Feasibility and safety of retroperitoneal laparoscopic adrenalectomy in day surgery mode

目的:探讨日间手术模式在后腹腔镜下肾上腺良性肿瘤治疗中的可行性及安全性。方法:回顾性分析我院于2020年5月~9月12例接受日间模式后腹腔镜下肾上腺肿瘤切除术治疗的肾上腺良性肿瘤患者的临床资料。所有患者均于门诊确诊,排除肾上腺嗜铬细胞瘤可能后,在门诊完善相关术前检查及化验,并经严格的麻醉评估及临床术者评估,符合日间准入标准。术前仔细准备,术后严密观察12例患者各项生命体征。于入院48h内拔除引流管,并行出院评估,符合出院标准后,办理出院。出院后1周内,我院主管医师每日行电话或网络随访,及时了解并完整记录患者一般生命体征及切口处渗出情况。出院后1周门诊复查皮质醇、电解质等。结果:12例肾上腺良性肿瘤患者均顺利完成日间后腹腔镜下肾上腺肿瘤切除术,于术后48h内拔除引流管出院,术后随访3个月,无明显并发症。结论:对于诊断肾上腺良性肿瘤且一般身体良好的患者,行日间模式下后腹腔镜手术是安全、可行的,可缩短术后患者拔管时间,显著降低住院天数,减少医疗费用。

Objective:To evaluate the feasibility and safety of retroperitoneal laparoscopic adrenalectomy in the treatment of adrenal tumor in the day surgery mode.Methods:The records of 12patients who underwent ret-roperitoneal laparoscopic adrenalectomy in day surgery mode for adrenal tumor from May 2020to September 2020 at our institution were analyzed retrospectively.Patients were clearly diagnosed in the outpatient clinic and exclu-ded the possibility of pheochromocytoma.The relevant preoperative examination,anesthesia evaluation and opera-tive appointment were completed.Careful preoperative preparation and observation of the vital signs after opera-tion were performed to ensure the successful treatment.The drainage tubes were removed at 24-48hours after operation.The patients were discharged when reaching the criteria.The patients were followed up for one week through internet or phone after they discharged,then the vital signs and the incision healing were recorded.Re-sults:All of the 12patients underwent successful operations in day surgery mode.Their drainage tubes were all re-moved before they discharged.During 3 months of follow-up period,no surgical complication occurred.Conclu-sion:The retroperitoneal laparoscopic adrenalectomy in the treatment of adrenal tumor in day surgery mode is safe and effective in appropriately selected patients.The length of stay and hospitalization expenses were much less.This strategy is worth promoting in clinical practice.