Guazzoni G, Cestari A, Montorsi F, Bellinzoni P, Centemero A, Naspro R, Salonia A, Rigatti P
Department of Urology, Università Vita-Salute, San Raffaele Hospital, Milan, Italy.
BJU Int. 2004 Jan;93(2):221-7. doi: 10.1111/j.1464-410x.2004.04586.x.
Since it was initially described in 1992 laparoscopic adrenalectomy (LA) has been gaining popularity amongst urologists and its range of applications has progressively widened. Ten years after the first report of LA this type of operation is presently considered to be the 'standard of care' for most adrenal diseases requiring surgery. We define the current role of laparoscopy in the management of surgical adrenal diseases, using a Medline search (1997-2002) to assess reports of LA, focusing on indications, approaches (transperitoneal and retroperitoneoscopic) and comparative analyses, taking particular care to evaluate operative duration, rate of conversion and transfusion, complications and hospital stay. With both approaches LA is safe and effective and, when compared with open surgery, offers the same functional results with all the advantages of minimally invasive surgery. We conclude that LA based on either approach should be considered the treatment of choice for benign adrenal lesions. Although very promising, conservative surgery and LA should still be evaluated in cases of malignancy.
自1992年首次描述以来，腹腔镜肾上腺切除术（LA）在泌尿外科医生中越来越受欢迎，其应用范围也在不断扩大。在LA首次报告十年后，目前这种手术类型被认为是大多数需要手术的肾上腺疾病的“标准治疗方法”。我们通过医学文献数据库检索（1997 - 2002年）来评估LA的报告，以确定腹腔镜检查在肾上腺外科疾病管理中的当前作用，重点关注适应症、手术入路（经腹和后腹腔镜）以及对比分析，特别注意评估手术时间、中转率和输血情况、并发症及住院时间。两种入路的LA都是安全有效的，与开放手术相比，能获得相同的功能效果，并具有微创手术的所有优点。我们得出结论，基于任何一种入路的LA都应被视为良性肾上腺病变的首选治疗方法。尽管前景非常广阔，但对于恶性病例，仍应评估保守手术和LA。
