Lang Bin, Fu Bin, OuYang Jin-Zhi, Wang Bao-Jun, Zhang Guo-Xi, Xu Kai, Zhang Jun, Wang Chao, Shi Tao-Ping, Zhou Hui-Xia, Ma Xin, Zhang Xu
Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
J Urol. 2008 Jan;179(1):57-60; discussion 60. doi: 10.1016/j.juro.2007.08.147. Epub 2007 Nov 12.
We compared the clinical outcomes of retroperitoneoscopic and open adrenalectomy for pheochromocytoma.
Clinical data on 56 patients who underwent retroperitoneoscopic lateral adrenalectomy were retrospectively compared with those on 50 who underwent open adrenalectomy for pheochromocytoma, including patient demographic data, perioperative indexes and clinical outcomes.
Demographic data on patients were similar in the 2 groups. In the retroperitoneoscopic group such perioperative indexes were significantly different from those of the open group (each p <0.05), including operative time (mean +/- SD 52 +/- 22 vs 120 +/- 42 minutes), estimated blood loss (74 +/- 34 vs 187 +/- 64 ml), resumption of oral intake (1 vs 2 days), postoperative hospital stay (5.2 +/- 1.7 vs 8.3 +/- 1.8 days), incidence of intraoperative hypertension (17.0% or 9 of 53 patients vs 36.0% or 18 of 50) and number of patients requiring blood transfusion(1.8% or 1 of 53 vs 16.0% or 8 of 50). The incidence of systemic inflammatory response syndrome was much less in the retroperitoneoscopic group (20.8% or 11 of 53 patients vs 42.0% or 21 of 50, p <0.05). However, the duration of systemic inflammatory response syndrome and postoperative complications were similar in the 2 groups (p >0.05). Blood pressure returned to normal 3 months after the operation in 81% of the patients in the retroperitoneoscopic group and in 84% in the open group. During the followup of 5 to 36 months no tumor recurrence and/or metastasis developed.
Compared with open surgery retroperitoneoscopic lateral adrenalectomy for pheochromocytoma is a safe, minimally invasive and effective procedure.
我们比较了后腹腔镜与开放性肾上腺切除术治疗嗜铬细胞瘤的临床疗效。
回顾性比较56例行后腹腔镜侧肾上腺切除术患者与50例行开放性肾上腺切除术治疗嗜铬细胞瘤患者的临床资料，包括患者人口统计学数据、围手术期指标及临床疗效。
两组患者的人口统计学数据相似。后腹腔镜组的围手术期指标与开放手术组相比有显著差异（均P<0.05），包括手术时间（平均±标准差52±22比120±42分钟）、估计失血量（74±34比187±64毫升）、恢复经口进食时间（1比2天）、术后住院时间（5.2±1.7比8.3±1.8天）、术中高血压发生率（17.0%或53例中的9例比36.0%或50例中的18例）及需要输血的患者数量（1.8%或53例中的1例比16.0%或50例中的8例）。后腹腔镜组全身炎症反应综合征的发生率更低（53例患者中的11例，占20.8%比50例患者中的21例，占42.0%，P<0.05）。然而，两组全身炎症反应综合征的持续时间及术后并发症相似（P>0.05）。后腹腔镜组81%的患者及开放手术组84%的患者术后3个月血压恢复正常。在5至36个月的随访期间，未发生肿瘤复发和/或转移。
与开放手术相比，后腹腔镜侧肾上腺切除术治疗嗜铬细胞瘤是一种安全、微创且有效的手术方法。
