【word】 后腹腔镜解剖性肾上腺肿瘤切除术38例临床分析.docVIP

后腹腔镜解剖性肾上腺肿瘤切除术38例临床分析 岭南现代J}缶床外科2011年2月第11卷第1期LingnanModemClinicsinSurgery.Feb2011.Vo1.11No.1 后腹腔镜解剖性肾上腺肿瘤切除术38例 临床分析 林建贵庄志明郑周达 【摘要】目的探讨后腹腔镜解剖性肾上腺肿瘤切除术的临床价值.方法对本科2005年 3月至2009年6月开展的38例后腹腔镜解剖性.肾上腺肿瘤切除术进行回顾性分析.38例中22 例为皮质醇腺瘤,14例为醛固酮腺瘤,2例嗜铬细胞瘤.结果38例手术均获成功.无大出血,感 染及腹腔脏器损伤等并发症.平均手术时间90min(45—130min),估计平均失血量55ml(25～ 90m1),无需输血.术后I-2d拔除引流管和尿管,平均住院5.6d(4～8d).术后随访6—24个月,平 均12个月,3例患者失访,其余患者术后临床症状和体征均恢复正常,未见肿瘤复发.结论后腹 腔镜解剖性肾上腺肿瘤切除术具有术野清晰,出血少,手术时间短和并发症少等优点,有望成为 肾上腺良性疾病首选手术方法. 【关键词】腹腔镜;后腹膜腔;.肾上腺肿瘤 中图分类号:R736.6文献标识码:A文章编号:1009—976X(2011)0l一0066—02 Retroperitoneallaparoscopicanatomicaladrenalectomyforadrenalglandtumors(Ananalysisof 38cases)LinJiangui,ZhuangZhiming,ZhengZhouda.DepartmentofUrology,ZhangzhouAffiliated HospitalofF均MedicalUnivers,Zhangzhou,i帆363000 【Abstract】ObjectiveToevaluateretroperitoneallaparoscopicanatomicaladrenalectomyfor benignadrenaltumors.MethodsFromMarch2005toJune2009,38caseswithbenignadrenal tumorsunderwentretroperitoneallaparoscopicanatomicaladrenalectomyinourhospita1.Theclinical datawererecordandanalyzed.Among38cases,therewere22caseswithcortisolasenoma,14cases withaldosterone—producingadenomaand2casewithadrenalpheochromocytoma.ResultsThe operationswereSuccessfulinall38caseswithoutmassivehemorrhage.infe?ctionorabdominalvisceral injury.Themeanoperationtimewas90min(rangefrom45to130min).Theestimatedmeanblood losswas55ml(rangefrom25to90m1)withouttransfusion,Drainageandcatheterwereremoved1～ 2dpostoperatively.Thepostoperativehospitalstaywas5.6d(3~14d).Thefollowuptimeranged from6to24months,withaBaverageof12months.Lossfollow—upwasin3cases.Theclinical manifestationof35caseswerenormalandnotumorrecurrencewasfound.ConclusionRetroperitoneal laparoscopicanatomicaladrenalectomyhasmanyadvantages,includingclearoperativefield,less bloodloss,shoaeroperativetimeandlesscomplications.Itshouldbeconsideredasthefirstchoiceof operativemethodforbenignadrenaldiseases. 【Keywords】Laparoscope;Retroperitonum;Adrenaltumors 腹腔镜技术已成为肾上腺疾病手术治疗的金标准.后 腹腔入路具有入路直接.对腹腔干扰小,解剖游离容易等 特点为国内医生的首选方法.20