Gill I S
Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Urol. 2001 Aug;166(2):429-36.
The current status of laparoscopic adrenal surgery was assessed.
A current MEDLINE search revealed 308 articles pertaining to laparoscopic surgery of the adrenal gland. Based on this literature review laparoscopic surgical anatomy, current indications and contraindications, and laparoscopic techniques were identified. The role of laparoscopic surgery for various adrenal disorders, including aldosteroma, pheochromocytoma, Cushing's syndrome, incidentaloma and adrenal cancer, were evaluated. Studies specifically comparing open versus laparoscopic adrenalectomy and the financial implications of laparoscopy were evaluated. Furthermore, newer advances in the minimally invasive management of surgical adrenal disease were identified.
Available data from multiple institutions imply that laparoscopic adrenal surgery is safe and efficacious for aldosteroma, pheochromocytoma, Cushing's disease and incidentaloma. Compared to open surgery laparoscopy provides equally effective treatment, while minimizing patient morbidity. Laparoscopic adrenalectomy is financially superior to open adrenalectomy. For adrenal cancer open surgery currently remains the treatment of choice.
In the majority of patients with surgical adrenal disease except those with adrenal cancer laparoscopy may now be considered an established treatment modality.
评估腹腔镜肾上腺手术的现状。
当前对MEDLINE的检索显示有308篇关于肾上腺腹腔镜手术的文章。基于该文献综述确定了腹腔镜手术解剖学、当前的适应证和禁忌证以及腹腔镜技术。评估了腹腔镜手术对各种肾上腺疾病的作用，包括醛固酮瘤、嗜铬细胞瘤、库欣综合征、偶发瘤和肾上腺癌。对专门比较开放手术与腹腔镜肾上腺切除术以及腹腔镜手术的经济影响的研究进行了评估。此外，还确定了肾上腺疾病微创治疗方面的新进展。
来自多个机构的现有数据表明，腹腔镜肾上腺手术对醛固酮瘤、嗜铬细胞瘤、库欣病和偶发瘤是安全有效的。与开放手术相比，腹腔镜手术提供同样有效的治疗，同时将患者的发病率降至最低。腹腔镜肾上腺切除术在经济上优于开放肾上腺切除术。对于肾上腺癌，开放手术目前仍是首选治疗方法。
除肾上腺癌患者外，大多数肾上腺疾病患者现在可将腹腔镜手术视为一种既定的治疗方式。
