Castillo Octavio A, Vitagliano Gonzalo, Cortes Oscar, Sánchez-Salas Rafael, Arellano Leonardo
From the Section of Endourology and Laparoscopic Urology, Department of Urology, Clínica Santa Maria, Santiago de Chile.
Arch Esp Urol. 2007 Mar;60(2):217-21. doi: 10.4321/s0004-06142007000200022.
[corrected] To evaluate the results of laparoscopic adrenalectomy for adrenal myelolipoma in a single center.
Between November 1999 and February 2006, 226 laparoscopic adrenalectomies were performed at our institution. 19 specimens corresponded with adrenal myelolipomas (8%). Mean patient age was 53.8 years (range 35 to 75) with male-to-female ratio 2:1. Clinical data was prospectively collected. Patient characteristics, lesion size evaluated by CT scan or MRI, surgical technique, operative time, operative blood loss, complications, conversion to open surgery and hospital stay were reviewed.
Nineteen adrenal myelolipomas were laparoscopically treated in eighteen patients. 16 lesions were located on the right adrenal gland (84%). Mean surgical time was 84.7 minutes (range 45 to 150). Average bleeding was 25.8 ml (range 0 to 300). Only one patient required a blood transfusion. There were no intraoperative complications or conversions to open surgery. Average hospital stay was 2.1 days (range 1 to 4); no complications were registered during the immediate postoperative period. Pathology reports confirmed all specimens as myelolipomas. Mean maximum tumor diameter was 8.6 cm (range 4.5 to 14).
Adrenal myelolipoma is an infrequent, benign entity which can occasionally become symptomatic due to spontaneous hemorrhage. Typical radiographic presentation permits conservative management in asymptomatic small masses. In cases where surgical treatment is advocated, laparoscopic surgery is a safe and feasible technique with reasonable operating time as well as limited blood loss, hospital stay and convalescence.
评估单中心腹腔镜肾上腺切除术治疗肾上腺髓样脂肪瘤的效果。
1999年11月至2006年2月，我们机构共进行了226例腹腔镜肾上腺切除术。19例标本为肾上腺髓样脂肪瘤（8%）。患者平均年龄53.8岁（范围35至75岁），男女比例为2:1。前瞻性收集临床数据。回顾患者特征、通过CT扫描或MRI评估的病变大小、手术技术、手术时间、术中失血、并发症、转为开放手术情况及住院时间。
18例患者接受了19例腹腔镜肾上腺髓样脂肪瘤治疗。16个病变位于右侧肾上腺（84%）。平均手术时间为84.7分钟（范围45至150分钟）。平均失血量为25.8毫升（范围0至300毫升）。仅1例患者需要输血。无术中并发症或转为开放手术情况。平均住院时间为2.1天（范围1至4天）；术后近期无并发症记录。病理报告证实所有标本均为髓样脂肪瘤。平均最大肿瘤直径为8.6厘米（范围4.5至14厘米）。
肾上腺髓样脂肪瘤是一种罕见的良性病变，偶尔可因自发性出血而出现症状。典型的影像学表现允许对无症状的小肿块进行保守治疗。在主张手术治疗的病例中，腹腔镜手术是一种安全可行的技术，手术时间合理，失血、住院时间及康复时间有限。
