Iinuma Masahiro, Tsuchiya Norihiko, Habuchi Tomonori, Ooyama Chikara, Satoh Shigeru, Matsuura Shinobu, Sato Kazunari, Kato Tetsuro
Department of Urology, Akita University School of Medicine.
Hinyokika Kiyo. 2004 Jun;50(6):401-4.
We performed 52 laparoscopic adrenalectomies between January 1997 and March 2003. In 51 patients, adrenal tumors were successfully removed laparoscopically. In one patient, the laparoscopic procedure was converted to open surgery because of insufflator's trouble and hemorrhage. Perioperative blood transfusion was required in two patients; one for intraoperative and another for postoperative bleeding. We compared laparoscopic adrenalectomy with conventional open surgery which had been performed in our clinic before the laparoscopic adrenalectomy era. The mean operative time of the laparoscopic adrenalectomy (187 +/- 59 min) was not significantly longer than that of the open surgery (193 +/- 49 min). The mean estimated blood loss of laparoscopic adrenalectomy (75 +/- 145 g) was significantly less than that of the open surgery (438 +/- 447 g). Time to oral intake and ambulation for laparoscopic adrenalectomy were significantly earlier than those of the open surgery. Operation time was significantly shortened as the experience of this surgery was accumulated. The results of our experience support the concept that laparoscopic adrenalectomy is safe and is a standard treatment for surgical treatment of adrenal tumors.
1997年1月至2003年3月期间,我们共进行了52例腹腔镜肾上腺切除术。51例患者的肾上腺肿瘤通过腹腔镜手术成功切除。1例患者因气腹机故障和出血,腹腔镜手术转为开放手术。2例患者需要围手术期输血,1例因术中出血,另1例因术后出血。我们将腹腔镜肾上腺切除术与在我们诊所腹腔镜肾上腺切除术时代之前进行的传统开放手术进行了比较。腹腔镜肾上腺切除术的平均手术时间(187±59分钟)并不显著长于开放手术(193±49分钟)。腹腔镜肾上腺切除术的平均估计失血量(75±145克)显著少于开放手术(438±447克)。腹腔镜肾上腺切除术患者开始经口进食和下床活动的时间明显早于开放手术患者。随着该手术经验的积累,手术时间显著缩短。我们的经验结果支持腹腔镜肾上腺切除术是安全的,并且是肾上腺肿瘤外科治疗的标准治疗方法这一观点。