Berends Frits J, Harst Erwin Van Der, Giraudo Giuseppe, Terkivatan Türkan, Kazemier Geert, Bruining Hajo A, De Herder Wouter W, Bonjer H Jaap
Department of Surgery, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
World J Surg. 2002 May;26(5):527-31. doi: 10.1007/s00268-001-0261-7. Epub 2002 Mar 1.
Although endoscopic adrenalectomy is advocated for small adrenocortical tumors, questions remain about the safety of endoscopic retroperitoneal resection of pheochromocytomas. In this study we evaluated the outcome of retroperitoneal endoscopic adrenalectomy for pheochromocytoma. Between June 1995 and September 1999 we performed 18 retroperitoneal endoscopic adrenalectomies for a pheochromocytoma or paraganglioma. All patients received adequate alpha-adrenergic blockade. The adrenal vein was ligated at the end of the procedure. Operative blood pressure values were recorded and evaluated. Altogether 15 patients (11 women, 4 men; mean age 47.2 years) were operated on for 17 pheochromocytomas and 1 extraadrenal tumor (4 right, 11 left, 3 bilateral). One female patient was operated on at 13 weeks' gestation. Hypertensive episodes at operation were seen in 4 (26.7%) patients, and tachycardia occurred in 5 (33%). Hemodynamic changes could be corrected in all cases using simple measures without morbidity or detrimental effects. The mean operating time was 125 minutes (80-180 minutes), and the conversion rate was 5.6% (1/18). The median hospital stay was 5 days (3-28 days). Morbidity was 20% (3/15). Endoscopic retroperitoneal adrenalectomy for pheochromocytoma is safe and effective, and it is associated with limited morbidity.
尽管内镜下肾上腺切除术适用于小的肾上腺皮质肿瘤，但对于嗜铬细胞瘤的内镜下腹膜后切除术的安全性仍存在疑问。在本研究中，我们评估了嗜铬细胞瘤腹膜后内镜肾上腺切除术的结果。1995年6月至1999年9月期间，我们对18例嗜铬细胞瘤或副神经节瘤患者进行了腹膜后内镜肾上腺切除术。所有患者均接受了充分的α-肾上腺素能阻滞剂治疗。手术结束时结扎肾上腺静脉。记录并评估术中血压值。共有15例患者（11例女性，4例男性；平均年龄47.2岁）接受了17例嗜铬细胞瘤和1例肾上腺外肿瘤（4例右侧，11例左侧，3例双侧）的手术。1例女性患者在妊娠13周时接受了手术。4例（26.7%）患者术中出现高血压发作，5例（33%）出现心动过速。所有病例的血流动力学变化均可通过简单措施得到纠正，且无并发症或不良影响。平均手术时间为125分钟（80 - 180分钟），中转率为5.6%（1/18）。中位住院时间为5天（3 - 28天）。并发症发生率为20%（3/15）。嗜铬细胞瘤的内镜下腹膜后肾上腺切除术安全有效，且并发症有限。
