Gumbs Andrew A, Gagner Michel
New York-Presbyterian Hospital, Division of Laparoscopic and Bariatric Surgery and Department of Surgery, Joan and Sanford I. Weill Medical College of Cornell University, PO Box 294, New York, NY 10021, USA.
Best Pract Res Clin Endocrinol Metab. 2006 Sep;20(3):483-99. doi: 10.1016/j.beem.2006.07.010.
Laparoscopic adrenalectomy (LA) was first described in the literature in 1992, and has become the preferred method for the removal of benign functioning and non-functioning tumors of the adrenal gland <12 cm. The objectives of the present study are to review the experience of LA gained since it was first done in 1992 and to critically evaluate its effectiveness for the surgical management of endocrine hypertension; specifically pheochromocytoma, aldosteronoma and Cushing's syndrome and disease, as opposed to open adrenalectomy. The benefits of minimally invasive techniques for the removal of the adrenal gland include decreased requirements for analgesics, improved patient satisfaction, shorter hospital stay and recovery time when compared to open surgery. LA can be performed safely for bilateral disease and may become the standard of care for malignant tumors. Current limitations are operator-dependent and not a factor of limitations of minimally invasive techniques. A thorough pre-operative work-up is key for differentiating the various cases of hypertension and adequate pre-operative treatment is paramount when indicated.
腹腔镜肾上腺切除术（LA）于1992年首次在文献中被描述，现已成为切除直径小于12 cm的肾上腺良性功能性和非功能性肿瘤的首选方法。本研究的目的是回顾自1992年首次开展LA以来所积累的经验，并严格评估其在内分泌性高血压手术治疗中的有效性；特别是与开放性肾上腺切除术相比，对嗜铬细胞瘤、醛固酮瘤以及库欣综合征和疾病的治疗效果。与开放性手术相比，采用微创技术切除肾上腺的益处包括减少镇痛药的使用需求、提高患者满意度、缩短住院时间和恢复时间。LA可安全地用于双侧疾病的治疗，并且可能成为恶性肿瘤的标准治疗方法。目前的局限性取决于手术操作者，而非微创技术本身的限制因素。全面的术前检查对于鉴别各种高血压病例至关重要，如有指征，充分的术前治疗至关重要。
