Matsuda T, Murota T, Kawakita M
Department of Urology, Kansai Medical University, Moriguchi, Osaka, Japan.
Biomed Pharmacother. 2000 Jun;54 Suppl 1:157s-160s. doi: 10.1016/s0753-3322(00)80034-7.
Four laparoscopic methods have been developed to approach the adrenal gland: anterior or lateral transperitoneal approaches, and lateral or posterior retroperitoneal approaches. The advantages and disadvantages of these methods were reviewed during a workshop held by the Japanese Society of Endourology and ESWL in 1997. The transperitoneal anterior approach, when combined with a lateral approach for the left side, is the easiest for small adrenal tumors, and discloses the adrenal vein early in the procedure. For large tumors over 5 cm in diameter, the transperitoneal lateral approach is the most feasible bilaterally. Regardless of the methods of approach, laparoscopic adrenalectomy has already become the standard procedure for adrenal tumors, because it minimizes the operative morbidity and postoperative hospital stay.
经腹腔前路或侧路入路，以及经腹膜后外侧或后路入路。1997年日本腔内泌尿外科学会和体外冲击波碎石术学会举办的一次研讨会上对这些方法的优缺点进行了回顾。经腹腔前路入路，若与左侧的侧路入路联合使用，对于小的肾上腺肿瘤而言是最简便的方法，并且在手术早期就能显露肾上腺静脉。对于直径超过5厘米的大肿瘤，经腹腔侧路入路在双侧操作时最为可行。无论采用何种入路方法，腹腔镜肾上腺切除术已成为肾上腺肿瘤的标准手术，因为它能将手术发病率和术后住院时间降至最低。
