El-Kappany Hamdy A, Shoma Ahmed M, El-Tabey Nasr A, El-Nahas Ahmed R, Eraky Ibrahim I
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
J Endourol. 2005 Dec;19(10):1170-3. doi: 10.1089/end.2005.19.1170.
To evaluate the surgical feasibility of laparoscopic adrenalectomy and what laparoscopy offers for the surgeon and the patient.
From March 1996 to June 2004, 43 transperitoneal laparoscopic adrenalectomies were performed for various pathological states. Functioning adrenal masses and solid masses>5 cm were the most common indications. The mean size of the masses on abdominal CT was 6.8 cm in the largest diameter. All patients were assessed regarding the operative time, blood loss, complications, and conversion to open surgery. The postoperative course was reported with special attention to the complications and hospital stay.
The mean operative time was 125 minutes with a mean blood loss of 60 mL. Intraoperative complications occurred in 3 cases (6.9%), necessitating conversion to open surgery in 2 to control bleeding from the avulsed right adrenal vein. A third case of conversion was elective because of difficult dissection of a large left pheochromocytoma from the renal hilum, so there was a 6.9% rate of conversion to open surgery. All patients showed early ambulation, early start of eating, and a short hospital stay (mean 2.6 days).
Laparoscopic adrenalectomy is surgically feasible and can be applied for different adrenal pathologies. The procedure can be performed with a reasonable operative time, minimal blood loss, and an acceptable rate of complications. Laparoscopic adrenalectomy provides excellent postoperative recovery and convalescence with a short hospital stay.
评估腹腔镜肾上腺切除术的手术可行性以及腹腔镜手术为外科医生和患者带来的益处。
1996年3月至2004年6月，针对各种病理状态实施了43例经腹腹腔镜肾上腺切除术。功能性肾上腺肿块和直径大于5 cm的实性肿块是最常见的适应证。腹部CT上肿块的平均最大直径为6.8 cm。评估所有患者的手术时间、失血量、并发症以及转为开放手术的情况。报告术后病程，特别关注并发症和住院时间。
平均手术时间为125分钟，平均失血量为60 mL。术中并发症发生3例（6.9%），其中2例因右侧肾上腺静脉撕裂出血需要转为开放手术以控制出血。第三例转为开放手术是因为从肾门处解剖一个大的左侧嗜铬细胞瘤困难，所以转为开放手术的比例为6.9%。所有患者均早期下床活动、早期进食，住院时间短（平均2.6天）。
腹腔镜肾上腺切除术在手术上是可行的，可应用于不同的肾上腺病变。该手术可以在合理的手术时间、最少的失血量和可接受的并发症发生率下进行。腹腔镜肾上腺切除术能实现极佳的术后恢复和康复，住院时间短。
