Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA.
J Surg Oncol. 2012 Oct 1;106(5):611-8. doi: 10.1002/jso.23250. Epub 2012 Aug 29.
Laparoscopic adrenalectomy is a mainstay of operative options for adrenal tumors and allows surgeons to perform adrenalectomies with less morbidity, less post-operative pain, and shorter hospital stays. The literature has demonstrated its efficacy to be equal to open adrenalectomy in most cases. With regard to malignant primary and metastatic lesions, controversy still remains, however, consideration of a laparoscopic approach for smaller, well circumscribed and non-invasive lesions is reasonable. During any laparoscopic resection, when there is doubt about the ability to safely remove the lesion with an intact capsule, conversion to an open approach should be considered. The primary goal of a safe and complete oncologic resection cannot be compromised. For most benign lesions, laparoscopic approaches are safe and feasible and conversion to an open approach is necessary only for lesions where size limits the ability of a minimally invasive resection.
腹腔镜肾上腺切除术是治疗肾上腺肿瘤的主要手术方法之一，它使外科医生能够以较低的发病率、较少的术后疼痛和更短的住院时间来进行肾上腺切除术。文献表明，在大多数情况下，它的疗效与开放肾上腺切除术相当。然而，对于恶性原发性和转移性病变，仍存在争议，但是对于较小、边界清晰且非侵袭性的病变，考虑采用腹腔镜方法是合理的。在任何腹腔镜切除过程中，如果对安全切除完整包膜下病变的能力有疑问，应考虑转为开放手术。安全、完整的肿瘤切除的主要目标不能妥协。对于大多数良性病变，腹腔镜方法是安全可行的，只有在病变大小限制了微创手术切除能力的情况下，才需要转为开放手术。
