嗜铬细胞瘤的外科治疗(附151例报告)

Surgical treatment of pheochromocytoma (report of 151 cases)

目的 提高嗜铬细胞瘤的治疗水平。 方法 总结 15 1例嗜铬细胞瘤术前准备、麻醉管理、手术操作及术后处理经验。男 82例 ,女 6 9例 ,年龄 15～ 73岁 ,平均 39岁。肾上腺内 12 0例 ,肾上腺外 31例。 结果 肿瘤切除术 132例 ,肿瘤囊内剜除术 12例 ,膀胱部分切除术 7例。术中死亡 1例。术后血压正常 136例 ,仍需持续用药控制 15例。良性嗜铬细胞瘤 137例 ,9例复发 ;恶性嗜铬细胞瘤 14例 ,其中 10例 5年内死于肿瘤转移。 结论 手术切除肿瘤是嗜铬细胞瘤的根治方法 ,正确的术前诊断和围手术期处理十分重要。

Objective To evaluate the surgical treatment of pheochromocytoma. Methods A total of 151 cases of pheochromocytoma were studied in regard to the preoperative preparation,anesthetic management,operative technique and postoperative treatment. Results Of the 151 cases 132 underwent total tumor excision,12 cases intracapsular excavation and 7 cases partial cystectomy.Only 1 patient died during the course of operation.Pathological examination showed that 137 cases were of benign pheochromocytoma and 14 cases of malignant.After operation 136 cases had normal blood pressure and 15 cases were treated with hypotensor to maintain normal blood pressure.Of the 137 cases of benign pheochromocytoma 9 experienced relapse.Of the 14 cases of malignancy 10 died of metastasis within 5 years. Conclusions Surgical excision is the fundamental approach for cure,and correct preoperative diagnosis and proper perioperative management are extremely important.