【word】 后腹腔镜肾上腺肿瘤切除术35例临床应用体会.doc

后腹腔镜肾上腺肿瘤切除术35例临床应用体会 18JBengbuMedColl,January2011,Vo1.36,No.1 [文章编号]1000-2200(2011)O1-0018-03?腔镜在泌尿外科的应用? 后腹腔镜肾上腺肿瘤切除术35例临床应用体会 关超,谷明利,方文革,许海斌,方习武,李庆文,徐卫强,谢海龙’,郭园园 [摘要]目的:探讨后腹腔镜肾上腺肿瘤切除术的临床应用价值.方法:经后腹腔途径行肾上腺肿瘤切除术35例.其中醛固 酮腺瘤15例,皮质腺瘤9例,嗜铬细胞腺瘤6例,无功能腺瘤5例.术前均经B超,CT或MRI检查证实为肾上腺占位性病变. 结果:35例均顺利完成手术,无严重并发症发生.手术时间50～160min,术中出血40～300ml.切除肿瘤直径1～6.5cm. 术后住院5～7天;出院后随访3～26个月,32例术后3个月内血压恢复正常,3例仍需服用降压药物.结论:后腹腔镜肾上腺 肿瘤切除术具有创伤小,术中出血少,术后恢复快等优点,是治疗.肾上腺良性肿瘤的首选方法,但需要根据肿瘤病理类型和体 积大小严格掌握适应证. [关键词]肾上腺肿瘤;肾上腺切除术;腹腔镜术 [中国图书资料分类法分类号]R736.6[文献标识码]A RetrOperitOneallaparoscopicadrenalectomyin35cases GUANChao,GUMing—li,FANGWen—ge,XUHai—bin,FANGXi—wn,LIQing—wen,XUWei—qia.g,XIEHai—long,GUOYuan—yuan (1.DepartmentofUrology,TheSecondAffiliatedHospitalofBengbuMedicalCollege,BengbuAnhui233040; 2.DepartmentofUrology,TheFirstAffiliatedHospitalofBengbuMedicalCollege,BengbuAnhui233004,China) [Abstract]objective:Toevaluatetheclinicalvalueofretroperitoneallaparoscopicadrenalectomyforbenignadrenaltumors. Methods:Retroperitoneallaparoscopicadrenalectomywasconductedin35casesofadrenaltumor.Thecasesincludedl5aldosterone— producingadenomas,9CushingSsyndromes,6pheochromocytomasand5nonfunctionaladrenaladenomas.BultrasoundandCT/MR1 wereusedtodiagnoseallpatientspreoperatively.Results:Alloperationswerecompletedsuccessfullywithoutanyseverecomplications. Thetimeoftheoperationswas50—160min.Thebloodlosswas40—300m1.Thediameteroftumorwas1—6.5cm.Thepostoperative hospitalstaywas5—7(1ays.Thepatientswerefollowedupfor3to26months.Normalbloodpressurewasachievedin32patientsin3 monthsafteroperationandoralantihypertensivedrugswerestillneededinother3patients.Conclusions:Retroperitoneallaparoscopic adrenalectomyshouldbeconsideredasthefirstchoicefortreatmentofbenignadrenaldiseaseswiththeadvantagesoflesstrauma,less bloodlossandfasterpostoperativerecovery.Indicationsshouldbaseonthepathologictypeandtumorsizestrictly. [Keywords]adrenalglandneoplasms;adrenalectomy;laparoscopy 自1992年Gagner等¨首次应用腹腔镜技术行 肾上腺肿瘤切除以来,腹腔镜肾上腺肿瘤切除术逐 渐得到广泛开展,已成为绝大多数肾上腺肿瘤治疗