Brunt L M
Department of Surgery, Institute for Minimally Invasive Surgery, Washington University School of Medicine, Campus Box 8109, St. Louis, MO 63110, USA.
Surg Endosc. 2006 Mar;20(3):351-61. doi: 10.1007/s00464-004-8269-3. Epub 2006 Jan 25.
Laparoscopic adrenalectomy has become the preferred method for removal of most adrenal tumors. An important component in selecting patients for this operation is to understand the clinical presentation and diagnostic workup for the various functioning and nonfunctioning adrenal tumors. In this review, an overview of the key clinical and diagnostic aspects of the most common adrenal tumors is presented. The indications and contraindications for a laparoscopic approach are discussed and the technique for laparoscopic adrenalectomy is then presented with inclusion of video links to demonstrate the technique. A review of the results of laparoscopic adrenalectomy is then considered with regard to common outcome measures and complications. A current controversy in adrenal surgery is the role of laparoscopic adrenalectomy in the management of patients with large tumors and malignant or potentially malignant adrenal lesions and the literature on this topic is reviewed in detail. The article concludes with a discussion of the indications and technique for partial adrenalectomy.
腹腔镜肾上腺切除术已成为大多数肾上腺肿瘤切除的首选方法。选择患者进行该手术的一个重要因素是了解各种功能性和非功能性肾上腺肿瘤的临床表现及诊断检查。在本综述中，将概述最常见肾上腺肿瘤的关键临床和诊断方面。讨论腹腔镜手术的适应证和禁忌证，然后介绍腹腔镜肾上腺切除术的技术，并包含视频链接以演示该技术。接着从常见的结果指标和并发症方面对腹腔镜肾上腺切除术的结果进行综述。肾上腺手术当前的一个争议是腹腔镜肾上腺切除术在处理大肿瘤以及恶性或潜在恶性肾上腺病变患者中的作用，并将详细综述该主题的文献。本文最后讨论了部分肾上腺切除术的适应证和技术。
