Department of Surgery, Oregon Health and Science University, OHSU M/C L223A, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Surg Endosc. 2010 Jun;24(6):1462-7. doi: 10.1007/s00464-009-0801-z. Epub 2009 Dec 24.
Laparoscopic adrenalectomy is the treatment of choice for most adrenal lesions. Concerns have persisted about its application to large pheochromocytomas due to reports of hemodynamic instability, difficult dissection, and tumor spillage.
Thirty patients underwent laparoscopic adrenalectomy for unilateral pheochromocytoma between 1998 and 2006. Outcome measures including operative time, blood loss, intraoperative hemodynamic instability, conversion rate, complications, and disease recurrence were analyzed based on tumor size.
Twenty-two patients had small tumors and eight had large lesions. These groups did not differ in terms of operative time, blood loss, conversion rate, length of stay or complication rate. Intraoperative hemodynamic instability occurred in 56.7% of cases, but was not different between groups. There were no recurrences in either group.
Laparoscopic adrenalectomy is a safe and effective treatment for large pheochromocytomas. Intraoperative hemodynamic instability remains a frequent occurrence regardless of tumor size. There were no cases of disease recurrence or iatrogenic pheochromocytosis.
腹腔镜肾上腺切除术是大多数肾上腺病变的首选治疗方法。由于有报道称其会导致血流动力学不稳定、难以分离和肿瘤溢出，因此对于大嗜铬细胞瘤的应用一直存在担忧。
1998 年至 2006 年间，30 名患者因单侧嗜铬细胞瘤接受了腹腔镜肾上腺切除术。根据肿瘤大小分析了手术时间、出血量、术中血流动力学不稳定、中转率、并发症和疾病复发等结果指标。
22 名患者肿瘤较小，8 名患者肿瘤较大。这两组在手术时间、出血量、中转率、住院时间或并发症发生率方面没有差异。术中血流动力学不稳定发生在 56.7%的病例中，但两组之间没有差异。两组均无复发。
腹腔镜肾上腺切除术是治疗大嗜铬细胞瘤的一种安全有效的方法。无论肿瘤大小如何，术中血流动力学不稳定仍然是一个常见的问题。没有疾病复发或医源性嗜铬细胞瘤的病例。
