Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea.
J Endourol. 2009 Dec;23(12):1957-60. doi: 10.1089/end.2009.0404.
The purpose of this study was to describe our initial clinical experience and assess the feasibility of laparoendoscopic single-site surgery (LESS) in the treatment of benign adrenal adenoma.
Nine patients undergoing LESS adrenalectomy for benign adrenal adenoma were compared with 17 patients undergoing conventional laparoscopic adrenalectomy. Controls were matched for age, sex, surgical indications, and tumor size via a statistically generated selection of all conventional laparoscopic adrenalectomies performed during the same period of time.
No significant differences in the mean operative time (169 vs. 144.5 minutes, p = 0.287), blood loss (177.8 vs. 204.7 mL, p = 0.792), and postoperative hospital stay (3.2 vs. 3.5 days, p = 0.525) were observed between the LESS and conventional laparoscopy group. However, postoperative pain, as measured by the number of days of intravenous (IV) patient controlled anesthesia use, was significantly lower in the LESS group (0.9 vs. 1.9 days, p = 0.047). Perioperative complications were similar between the two groups.
LESS adrenalectomy for benign adrenal adenoma is comparable to the conventional laparoscopic approach with regard to the operative time, blood loss, length of hospital stay, and degree of complication, and has demonstrated more desirable cosmetic outcomes.
本研究旨在描述我们的初步临床经验，并评估腹腔镜单部位手术（LESS）治疗良性肾上腺腺瘤的可行性。
将 9 例行 LESS 肾上腺切除术治疗良性肾上腺腺瘤的患者与 17 例行传统腹腔镜肾上腺切除术的患者进行比较。通过对同期所有行传统腹腔镜肾上腺切除术的患者进行统计学生成的选择，将对照组患者按年龄、性别、手术适应证和肿瘤大小进行匹配。
LESS 组和传统腹腔镜组之间的平均手术时间（169 分钟 vs. 144.5 分钟，p = 0.287）、出血量（177.8 毫升 vs. 204.7 毫升，p = 0.792）和术后住院时间（3.2 天 vs. 3.5 天，p = 0.525）均无显著差异。然而，LESS 组的术后疼痛（通过静脉自控镇痛使用天数衡量）明显低于传统腹腔镜组（0.9 天 vs. 1.9 天，p = 0.047）。两组围手术期并发症相似。
LESS 肾上腺切除术治疗良性肾上腺腺瘤在手术时间、出血量、住院时间和并发症程度方面与传统腹腔镜方法相当，但具有更理想的美容效果。
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