机器人辅助腹腔镜肾上腺切除术治疗大体积肾上腺嗜铬细胞瘤效果分析

Perioperative analysis of robot-assisted laparoscopy in treatment of large adrenal pheochromocytoma

目的探讨机器人辅助腹腔镜肾上腺切除术治疗大体积(≥5 cm)肾上腺嗜铬细胞瘤的安全性、可行性。方法回顾性分析郑州大学第一附属医院泌尿外科2015-01—2021-08收治的大体积肾上腺嗜铬细胞瘤患者的临床资料。分为机器人辅助腹腔镜肾上腺切除术组(RALA组,28例)和腹腔镜肾上腺切除术组(LA组,29例)。比较2组患者的术中及术后恢复情况,统计术后并发症发生率。结果2组患者的一般资料,以及术中出血量、输血率、血管活性药物使用率、血流动力学不稳定发生率和术后ICU转入率、引流管拔除时间、并发症发生率的差异均无统计学意义(P>0.05)。RALA组的手术时间和术后住院时间均短于LA组,差异有统计学意义(P<0.05)。结论对于大体积肾上腺嗜铬细胞瘤患者,机器人辅助腹腔镜与传统腹腔镜肾上腺切除术具有相同的安全性、可行性。但机器人辅助腹腔镜肾上腺切除术具有更加灵活、高效,以及能缩短手术时间和术后住院时间等优势。

Objective To investigate the safety and feasibility of robot-assisted laparoscopic adrenalectomy in treatment of large adrenal pheochromocytoma(tumor diameter≥5 cm).Methods The clinical data of patients with large adrenal pheochromocytoma admitted to the Department of Urology,The First Affiliated Hospital of Zhengzhou University from 2015-01 to 2021-08 were retrospectively analyzed.They were divided into robot-assisted laparoscopic adrenalectomy group(RALA group,28 cases)and laparoscopic adrenalectomy group(LA group,29 cases).The intraoperative and postoperative recovery of the two groups were compared,and the incidence of postoperative complications was counted.Results There were no significant differences in the general data,intraoperative blood loss,blood transfusion rate,vasoactive drug use rate,incidence of hemodynamic instability,postoperative ICU transfer rate,drainage tube removal time,and complication rate between the two groups(P>0.05).The operative time and postoperative hospital stay in the RALA group were shorter than those of the LA group,and the differences were statistically significant(P<0.05).Conclusion For patients with large adrenal pheochromocytoma,robot-assisted laparoscopy has the same safety and feasibility as traditional laparoscopic adrenalectomy.However,robot-assisted laparoscopic adrenalectomy has the advantages of being more flexible,efficient,and shortening the operative time and postoperative hospital stay.