Bentrem David J, Pappas Sam G, Ahuja Yogesh, Murayama Kenric M, Angelos Peter
Department of Surgery, Division of Gastrointestinal and Endocrine Surgery, Galter Pavilion 10-105, Northwestern University Medical Center, Chicago, IL 60611, USA.
Am J Surg. 2002 Dec;184(6):621-4; discussion 624-5. doi: 10.1016/s0002-9610(02)01097-8.
The availability of laparoscopic adrenalectomy led us to review our experience and management of adrenal and extraadrenal pheochromocytoma.
Seventeen patients undergoing pheochromocytoma resection from January 1997 to August 2001 were categorized as open, laparoscopic, or laparoscopic assisted depending on the surgical approach. Hospital records were reviewed.
There was no significant difference between the groups in patient age, weight or preoperative blockade. Operative times for open, laparoscopic, and laparoscopic assisted adrenalectomies were 202, 218, and 260 minutes, respectively. Estimated blood loss was 562 cc, 187 cc, and 925 cc. The average hospital length of stay was 6.2, 3.0, and 5.8 days.
Laparoscopic removal resulted in longer operative times than open, but less operative blood loss and a shorter hospital stay. The laparoscopic assisted approach did not save time nor did it lead to earlier discharge. Laparoscopic adrenalectomy was comparable to the open approach, and is preferential in tumors less than 6 cm. An open approach remains our choice for larger or extraadrenal tumors.
腹腔镜肾上腺切除术的应用促使我们回顾肾上腺及肾上腺外嗜铬细胞瘤的治疗经验及处理方式。
1997年1月至2001年8月期间接受嗜铬细胞瘤切除术的17例患者，根据手术方式分为开放手术组、腹腔镜手术组或腹腔镜辅助手术组。回顾医院记录。
各组患者年龄、体重或术前阻滞剂使用情况无显著差异。开放手术、腹腔镜手术及腹腔镜辅助肾上腺切除术的手术时间分别为202分钟、218分钟和260分钟。估计失血量分别为562毫升、187毫升和925毫升。平均住院时间分别为6.2天、3.0天和5.8天。
腹腔镜切除术的手术时间比开放手术长，但术中失血量少，住院时间短。腹腔镜辅助手术方法既未节省时间，也未使患者更早出院。腹腔镜肾上腺切除术与开放手术相当，对于小于6厘米的肿瘤更具优势。对于较大或肾上腺外肿瘤，我们仍选择开放手术。
