Zimmerman P, DaSilva M, Newman T, Marx W, Simon H
Department of Surgery, State University of New York, Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
Surg Endosc. 2004 May;18(5):870. doi: 10.1007/s00464-003-4533-1.
Multiple endocrine neoplasia (MEN 2) is a rare disorder. Of this group, 42% develop a pheochromocytoma of which 60% will have bilateral involvement. Although the benefits of unilateral laparoscopic adrenalectomy have been well documented, fewer cases of simultaneous bilateral laparoscopic adrenalectomy have been reported. We present the cases of three patients with MEN 2 who underwent successful simultaneous bilateral laparoscopic adrenalectomy after their initial presentation with bilateral pheochromocytoma. Although the management of bilateral pheochromocytomas has traditionally been approached via open laparotomy or bilateral posterior incisions, the bilateral laparoscopic approach should be considered a viable alternative for patients requiring surgical intervention. Clinical outcomes and complications are similar to open laparotomy. Simultaneous bilateral laparoscopic adrenalectomy is a safe and effective procedure that results in a more rapid recovery and a shorter hospital stay for patients with bilateral pheochromocytomas originating from MEN 2.
多发性内分泌腺瘤病(MEN 2)是一种罕见的疾病。在这一群体中,42%会发生嗜铬细胞瘤,其中60%会双侧受累。尽管单侧腹腔镜肾上腺切除术的益处已有充分记录,但同时进行双侧腹腔镜肾上腺切除术的病例报告较少。我们报告了3例MEN 2患者的病例,他们在首次出现双侧嗜铬细胞瘤后成功接受了同时双侧腹腔镜肾上腺切除术。尽管双侧嗜铬细胞瘤的传统治疗方法是通过开放剖腹手术或双侧后入路切口,但对于需要手术干预的患者,双侧腹腔镜手术方法应被视为一种可行的替代方案。临床结果和并发症与开放剖腹手术相似。同时双侧腹腔镜肾上腺切除术是一种安全有效的手术,对于起源于MEN 2的双侧嗜铬细胞瘤患者,可使其恢复更快,住院时间更短。