腹腔镜手术治疗嗜铬细胞瘤的疗效与安全性
Efficacy and safety of laparoscopic surgery for pheochromocytoma.
作者信息
Naya Yukio, Ichikawa Tomohiko, Suzuki Hiroyoshi, Komiya Akira, Nagata Maki, Ueda Takeshi, Yamaguchi Kunio, Ito Haruo
机构信息
Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
出版信息
Int J Urol. 2005 Feb;12(2):128-33. doi: 10.1111/j.1442-2042.2005.01015.x.
OBJECTIVE
Laparoscopic surgery for primary aldosteronoma and Cushing's syndrome is well established. We report on our experiences with laparoscopic adrenalectomy for pheochromocytoma, and assess the efficacy and safety of the laparoscopic approach.
METHODS
Between April 1998 and April 2003, a total of 23 patients underwent laparoscopic adrenalectomy for pheochromocytoma at Chiba University Hospital and Yokohama Rosai Hospital, Japan. We compared the surgical outcomes of these patients with those of 106 patients with adrenal tumors due to other pathologies who underwent laparoscopic adrenalectomy during the same period.
RESULTS
The mean tumor size of pheochromocytoma was 4.96 cm. Mean operative time was 192.7 min, and mean estimated blood loss was 130 mL. Neither mean operative time nor mean estimated blood loss was greater for patients with pheochromocytoma. Intraoperative hypertension (systolic blood pressure > 180 mmHg) occurred in 39.1% (9/23) of patients with pheochromocytoma. During the follow-up period, there were no mortalities or recurrences of endocrinopathy.
CONCLUSIONS
Laparoscopic adrenalectomy for pheochromocytoma is a safe and minimally invasive procedure.
目的
腹腔镜手术治疗原发性醛固酮增多症和库欣综合征已得到广泛认可。我们报告腹腔镜肾上腺切除术治疗嗜铬细胞瘤的经验，并评估腹腔镜手术方法的有效性和安全性。
方法
1998年4月至2003年4月，日本千叶大学医院和横滨罗赛医院共有23例患者接受了腹腔镜肾上腺切除术治疗嗜铬细胞瘤。我们将这些患者的手术结果与同期106例因其他病变接受腹腔镜肾上腺切除术的肾上腺肿瘤患者的结果进行了比较。
结果
嗜铬细胞瘤的平均肿瘤大小为4.96 cm。平均手术时间为192.7分钟，平均估计失血量为130 mL。嗜铬细胞瘤患者的平均手术时间和平均估计失血量均未增加。39.1%（9/23）的嗜铬细胞瘤患者术中出现高血压（收缩压>180 mmHg）。在随访期间，没有死亡病例或内分泌病复发。
结论
腹腔镜肾上腺切除术治疗嗜铬细胞瘤是一种安全且微创的手术。
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