Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Urology. 2011 Jan;77(1):131-5. doi: 10.1016/j.urology.2010.03.094. Epub 2010 Aug 30.
To evaluate the safety and efficacy of retroperitoneal laparoscopic resection for pheochromocytoma.
The clinical data of 131 cases of pheochromocytoma were analyzed retrospectively. There were 69 males and 62 females with an age range of 8 to 77 years, including 120 cases of adrenal pheochromocytoma and 11 extraadrenal pheochromocytomas. Retroperitoneal laparoscopic resection was performed in all cases. We divided our practical experience into three stages: (1) the tentative and exploratory stage, (2) the accumulative stage, and (3) the mature stage.
During the tentative and exploratory stage, 10 patients underwent retroperitoneal laparoscopic surgery. The mean diameter of the tumor was 4.2 cm. The mean operation time was 105 minutes, and the median volume of blood loss during surgery was 450 mL. During the accumulative stage, the mean tumor diameter of the 72 cases was 5.6 cm. The mean operation time was 85 minutes and median volume of blood loss was 140 mL. During the mature stage, the mean tumor diameter of the 49 cases (including 11 extra-adrenal pheochromocytoma patients) was 6.7 cm. The mean operation time was 75 minutes and median volume of blood loss was 70 mL. Follow-ups ranging from 1 to 70 months were conducted, with three cases recurring. There were no cases of distant metastases or death.
Retroperitoneal laparoscopic surgery for pheochromocytoma is feasible and safe. This procedure will be increasingly performed as medical personnel continue to develop their skills and accumulate experience.
评估后腹腔镜切除嗜铬细胞瘤的安全性和有效性。
回顾性分析 131 例嗜铬细胞瘤患者的临床资料。男 69 例,女 62 例;年龄 8~77 岁,其中肾上腺嗜铬细胞瘤 120 例,肾上腺外嗜铬细胞瘤 11 例。所有患者均行后腹腔镜切除术。将我们的实践经验分为三个阶段:(1)试探性和探索性阶段,(2)积累阶段,(3)成熟阶段。
在试探性和探索性阶段,10 例患者接受了后腹腔镜手术。肿瘤的平均直径为 4.2cm。平均手术时间为 105 分钟,术中中位出血量为 450ml。在积累阶段,72 例患者的平均肿瘤直径为 5.6cm。平均手术时间为 85 分钟,中位出血量为 140ml。在成熟阶段,49 例患者(包括 11 例肾上腺外嗜铬细胞瘤患者)的平均肿瘤直径为 6.7cm。平均手术时间为 75 分钟,中位出血量为 70ml。随访 1~70 个月,复发 3 例。无远处转移或死亡病例。
后腹腔镜切除嗜铬细胞瘤是可行和安全的。随着医务人员技能的提高和经验的积累,该手术将越来越多地被应用。