Zamir G, Hazzan D, Gross D J, Lyass S, Jurim O, Shiloni E, Reissman P
Dept. of Surgery, Hadassah University Hospital, Ein-Kerem, Jerusalem.
Harefuah. 2000 Apr 2;138(7):531-4, 616, 615.
Constant advances and increasing experience in laparoscopic surgery renders it applicable for adrenal surgery. The wide exposure required for open adrenal surgery makes this minimally invasive procedure an attractive and advantageous alternative. Between 1996-1999, we performed 35 laparoscopic adrenalectomies in 30 patients 20-72-years old. Indications included: Conn's syndrome--14, pheochromocytoma--11, Cushing's syndrome--6, nonfunctioning adenoma--3, and metastatic sarcoma--1. 5 underwent bilateral laparoscopic adrenalectomy. In 3 (8.5%) the procedures were converted to open operations. Overall morbidity was 13% and there was no mortality. Mean operative time was 188 minutes, but only 130 in our last 10 cases. Mean hospital stay was 4 days and they returned to normal activity an average of 2 weeks later. According to our study and previous reports, laparoscopic adrenalectomy is feasible and safe and it may soon become the procedure of choice for adrenal tumors.
腹腔镜手术的不断进步和经验的日益积累使其适用于肾上腺手术。开放肾上腺手术所需的广泛暴露使得这种微创手术成为一种有吸引力且具有优势的替代方法。在1996年至1999年期间,我们对30例年龄在20至72岁的患者进行了35例腹腔镜肾上腺切除术。适应症包括:原发性醛固酮增多症——14例,嗜铬细胞瘤——11例,库欣综合征——6例,无功能腺瘤——3例,转移性肉瘤——1例。5例接受了双侧腹腔镜肾上腺切除术。3例(8.5%)手术转为开放手术。总体发病率为13%,无死亡病例。平均手术时间为188分钟,但我们最后10例的平均手术时间仅为130分钟。平均住院时间为4天,他们平均在2周后恢复正常活动。根据我们的研究和先前的报告,腹腔镜肾上腺切除术是可行且安全的,它可能很快成为肾上腺肿瘤的首选手术方法。