[doc] 后腹腔镜肾上腺肿瘤切除术78例报告.docVIP

后腹腔镜肾上腺肿瘤切除术78例报告 ? 1018?中国微创外科杂志2009年11月第9卷第1期ChinJM!!堡!!!!!!!!!::!: 后腹腔镜肾上腺肿瘤切除术78例报告 杨文增崔振宇赵春利周洪月张彦桥王全胜魏若晶马涛 (河北大学附属医院泌尿外科,保定071000) ? 临床论着? 【摘要】目的探讨后腹腔镜肾上腺肿瘤切除术的价值.方法2003年3月～2008年5月对78例肾上腺肿瘤行后 腹腔镜肾上腺切除术.腰部3个trocar穿刺入路,观察镜直接推移法建立后腹膜腔,用超声刀将肿瘤切除.结果78例手 术均取得成功,未输血.手术时间45～18Omin,平均90rain.术后24h拔除引流管,术后3—5d出院.1例有局部皮下气肿, 术后自行吸收,未出现其他并发症.72例术后随访3～24个月,平均10个月,36例术后3个月内血压恢复正常,7例仍需口服 降压药物,肿瘤局部无复发.结论后腹腔镜肾上腺切除术具有安全,有效,创伤小,术后恢复快,住院时间短等优点,是治 疗肾上腺良性肿瘤的首选方法. 【关键词】后腹腔镜;肾上腺肿瘤;肾上腺切除术 中图分类号:R736.6文献标识:A文章编号:1009—6604(2009)11—10l8一O3 Retr0peritonealLaparoscopicAdrenalcctomyin78CasesYangWenzeng,CuiZhenyu,ZhaoChunli,eta1.Departmentof Urology,HospitalAffiliatedtoHebeiUniversity,Baoding071000,China 【Abstract】ObjectiveToevaluatethevalueofretroperitoneallaparoscopicadrenalectomyforbenignadrenaltumors. MethodsFromMarch2003toMay2008,78patientswithadrenaltumorsreceivedretroperitoneallaparoscopicadrenalectomyinour hospita1.Duringtheoperation,threetrocarswereintroducedintothelumbarregiontoestablishretroperitonealspacebybluntdissection withthecamera.Afterwards,thetumorwasremovedbyusingaharmonicscalpe1.ResultsTheproceduresweresuccessfully completedinallthe78caseswithoutbloodtransfusion.theoperationtimerangedfrom45to180min(mean,90min).Drainagetubes wereremoved24hoursaftertheoperation.Andthepatientsweredischargedfromhospitalin3to5dayspostoperation.Onepatient showedregionalsubcutaneousemphysemaafterthesurgeryandwascuredspontaneously.Thepatientswerefollowedupfor3to24 monthswithameanof10months,duringwhich36patientsachievednormalbloodpressurein3months,whileintheother7patients, oralantihypertensiondrugswerestillneeded.Nopatientshadrecurrenttumorduringthefollow—up.ConclusionsRetroperitoneal laparoscopiccanbethefirstchoiceforadrenaltumors,asitissafeandeffectivewithminimalinvasion,quickrecovery,andshort postoperativehospitalstay. 【KeyWords】Retroperitoneallaparoscopy;Adrenaladenoma;Adrenaleetomy 自从1992年Gagner等.首次应用腹腔镜技术 行肾上腺肿瘤切除术以来,腹腔镜肾上腺肿瘤切除 术逐渐得到广泛开展.腹腔镜肾上腺肿瘤切除包括 经腹腔途径及经后腹腔途径,经后腹腔途径以其对 腹腔干扰小,术后胃肠道功能恢复快,住院时