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经腹腹腔镜肾上腺切除术治疗肾上腺肿瘤:371例报告

[Transperitoneal laparoscopic adrenalectomy for adrenal neoplasm: a report of 371 cases].

作者信息

Zhang Xue-Pei, Wei Jin-Xing, Zhang Wei-Xing, Wang Zhi-Yong, Wu Yu-Dong, Song Dong-Kui

机构信息

The First Affiliated of Zhengzhou,Henan, People's Republic of China.

出版信息

Ai Zheng. 2009 Jul;28(7):730-3. doi: 10.5732/cjc.009.10045.

Abstract

BACKGROUND AND OBJECTIVE

Open adrenalectomy has been almost replaced by mini-invasive laparoscopic surgery. There are two popular mini-invasive laparoscopic adrenalectomy approaches: retroperitoneal and transperitoneal approaches. This study was to summarize our experience in transperitoneal laparoscopic adrenalectomy.

METHODS

In total 371 cases undergoing transperitoneal adrenalectomy in the First Affiliated Hospital of Zhengzhou University from February 2003 to August 2008 were reviewed retrospectively. There were 127 cases of primary hyperaldosteronism adenoma, 117 cases of Cushing's adenoma, 58 cases of phaeochromo-cytoma, 37 cases of incidentoma and 32 cases of other types. The type of adrenal diseases, operating time, blood loss, complications and prognosis were summarized and the operating method was analyzed.

RESULTS

Three hundred and sixty-five out of 371 patients (98.4%) were successfully operated, five cases (1.4%) were transferred to open surgery, and one patient gave up surgery due to extensive invasion. The operating time was 40-240 min (average, 70 min). The blood loss was 20-1000 ml (average, 80 ml). Two patients suffered from diaphragm injuries, one patient had right renal vein injury and one had colon injury. The mean time of hospital stay was five days.

CONCLUSION

Transperitoneal laparoscopic adrenalectomy is one of the favorable approaches for the treatment of adrenal neoplasm.

摘要

背景与目的

开放性肾上腺切除术几乎已被微创腹腔镜手术所取代。有两种常见的微创腹腔镜肾上腺切除术方法:腹膜后途径和经腹途径。本研究旨在总结我们经腹腹腔镜肾上腺切除术的经验。

方法

回顾性分析2003年2月至2008年8月在郑州大学第一附属医院接受经腹肾上腺切除术的371例患者。其中原发性醛固酮增多症腺瘤127例,库欣腺瘤117例,嗜铬细胞瘤58例,偶发瘤37例,其他类型32例。总结肾上腺疾病类型、手术时间、出血量、并发症及预后情况,并分析手术方法。

结果

371例患者中365例(98.4%)手术成功,5例(1.4%)中转开放手术,1例因广泛侵犯放弃手术。手术时间为40 - 240分钟(平均70分钟)。出血量为20 - 1000毫升(平均80毫升)。2例患者发生膈肌损伤,1例右肾静脉损伤,1例结肠损伤。平均住院时间为5天。

结论

经腹腹腔镜肾上腺切除术是治疗肾上腺肿瘤的良好方法之一。

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