Shen Xiaocao, Qiu Yiqing, Zheng Yichun, Zhang Suzhan
Department of Urology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):578-80. doi: 10.1089/lap.2012.0113. Epub 2012 Jun 11.
Removing relatively large adrenal myelolipomas using retroperitoneal laparoscopy is difficult and carries risk of intraoperative injury to adjacent organs and vessels. We aimed to introduce a new method of retroperitoneal laparoscopic liposuction with suction units for resection of large adrenal myelolipomas.
From June 2005 to October 2011, 8 patients (nine lesions, including bilateral lesions in 1 patient) with adrenal myelolipoma more than 8 cm in maximum diameter underwent retroperitoneal laparoscopic liposuction with suction units. Patients included 3 males and 5 females with a mean age of 47 years (range, 35-62 years). Tumor resection was performed after deflation and shrinkage of tumor. The mean maximum diameter was 10.5 cm, ranging from 8 to 14 cm. Five tumors were located on the right side, two were on the left side, and one was bilateral. Adrenal computed tomography was done in each patient preoperatively. Round or oval masses were found in dense fat in the adrenal area, and all cases were diagnosed as adrenal myelolipoma. Five patients had backache or abdominal discomfort; three patients had no symptoms.
The mean operation time was 75 minutes, and the mean intraoperative blood loss was 30 mL. The mean postoperative length of stay was 3 days. No significant intraoperative or postoperative complications occurred. The follow-up length ranged from 8 to 77 months. No tumor recurrence was observed.
Retroperitoneal laparoscopic liposuction with suction units is safe and effective for resection of relatively large adrenal myelolipomas. Deflation and shrinkage of the tumor make the operation safer and easier without affecting its pathological diagnosis.
采用腹膜后腹腔镜技术切除较大的肾上腺髓样脂肪瘤难度较大，且有术中损伤邻近器官和血管的风险。我们旨在介绍一种使用吸引装置进行腹膜后腹腔镜抽脂术切除较大肾上腺髓样脂肪瘤的新方法。
2005年6月至2011年10月，8例（9个病灶，其中1例为双侧病灶）最大直径超过8 cm的肾上腺髓样脂肪瘤患者接受了使用吸引装置的腹膜后腹腔镜抽脂术。患者包括3例男性和5例女性，平均年龄47岁（范围35 - 62岁）。在肿瘤放气缩小后进行肿瘤切除。平均最大直径为10.5 cm，范围为8至14 cm。5个肿瘤位于右侧，2个位于左侧，1个为双侧。每位患者术前均进行了肾上腺计算机断层扫描。在肾上腺区域的致密脂肪中发现圆形或椭圆形肿块，所有病例均诊断为肾上腺髓样脂肪瘤。5例患者有背痛或腹部不适；3例患者无症状。
平均手术时间为75分钟，平均术中出血量为30 mL。术后平均住院时间为3天。未发生明显的术中或术后并发症。随访时间为8至77个月。未观察到肿瘤复发。
使用吸引装置的腹膜后腹腔镜抽脂术对于切除相对较大的肾上腺髓样脂肪瘤是安全有效的。肿瘤放气缩小使手术更安全、更容易，且不影响其病理诊断。
