Pascual Piédrola J I, Rincón Mayans A, Tolosa Eizaguirre E, Barba Abad J, Romero Vargas L, Rosell Costa D
Departamento de Urología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Actas Urol Esp. 2010 Feb;34(2):201-5. doi: 10.1016/s2173-5786(10)70041-x.
To assess the peroperative and oncological results of laparoscopic adrenalectomy for an isolated metastasis.
A retrospective, descriptive study was conducted of 12 laparoscopic adrenalectomies performed for metastases out of a total of 40 adrenalectomies performed from May 1998 to April 2009. The primary tumor was pulmonary in 7 patients, renal in 3, and colonic in 2. Demographic data collected included median age, operating time, blood loss, complications, tumor size, and length of hospital stay. The Kaplan-Meier method was used to analyze survival.
Operating time was 150 min (range, 90-206). Peroperative bleeding was 60 ml (range, 15-150). Peroperative complications occurred in 3% of patients. Tumor size was 4.5 cm (range, 1.3-8.5). No positive margins were seen in the resected specimens. Hospital stay was 3 days (range 3-5). Actuarial survival was 55.6% at 23 months (range, 2-38) with mean and median follow-up times of 20.9 and 23 months.
In selected patients, laparoscopic adrenalectomy for metastasis is a safe procedure with oncological results superimposable to those of open surgery.
评估腹腔镜肾上腺切除术治疗孤立性转移瘤的手术效果及肿瘤学结局。
对1998年5月至2009年4月期间共40例肾上腺切除术中，因转移瘤而行的12例腹腔镜肾上腺切除术进行回顾性描述性研究。原发肿瘤为肺癌的有7例，肾癌3例，结肠癌2例。收集的人口统计学数据包括年龄中位数、手术时间、失血量、并发症、肿瘤大小及住院时间。采用Kaplan-Meier法分析生存率。
手术时间为150分钟（范围90 - 206分钟）。术中出血60毫升（范围15 - 150毫升）。3%的患者出现术中并发症。肿瘤大小为4.5厘米（范围1.3 - 8.5厘米）。切除标本未见切缘阳性。住院时间为3天（范围3 - 5天）。23个月时的精算生存率为55.6%（范围2 - 38个月），平均随访时间和中位随访时间分别为20.9个月和23个月。
对于选定的患者，腹腔镜肾上腺切除术治疗转移瘤是一种安全的手术，其肿瘤学结局与开放手术相当。
