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越南德医院的单孔腹腔镜肾上腺切除术。

Single-incision laparoscopic adrenalectomy at Viet Duc University Hospital.

作者信息

Tran Giang Binh, Nguyen Tien Duc, Le Khanh Viet

机构信息

Department of General Surgery, Viet Duc University Hospital, Hanoi, Vietnam.

出版信息

Asian J Endosc Surg. 2013 Feb;6(1):33-8. doi: 10.1111/j.1758-5910.2012.00157.x. Epub 2012 Sep 18.

Abstract

INTRODUCTION

Laparoscopic adrenalectomy is the technique of choice in the treatment of adrenal tumors. SILS has recently been introduced in this field and applied in Viet Duc University Hospital. Herein, we report our experience with single-incision transperitoneal adrenalectomy.

METHODS

Between August 2010 and January 2012, 61 patients (23 men, 38 women) underwent SILS adrenalectomy at our institution. The diagnoses consisted of 20 patients with pheochromocytoma, 17 with nonfunctioning adenoma, 16 with Conn syndrome, 4 with Cushing syndrome and 4 with adrenal cysts. The mean age was 47.8 years (range, 21-68 years). There were 29 right-sided and 32 left-sided tumors; their mean diameter was 30.7 mm (range, 8-59 mm). Patients were in the flank position with the operated side up. A 2.5-cm pararectal incision at the level of the umbilicus was made to insert the SILS Port.

RESULTS

The mean operating time was 78 min (range, 50-120 min), and mean blood loss was approximately 70 mL. Left-sided tumors were excised entirely with the SILS technique. Right-sided lesions sometimes required an additional trocar (hybrid technique). No drainage was needed at the operating site. There were no intraoperative or postoperative complications, but one case was converted to the conventional three-port technique. The mean length of hospital stay was 3.4 days (range, 2-6 days).

CONCLUSION

Our preliminary results show that SILS adrenalectomy is safe and technically feasible. It should be considered among the surgical managements for selected patients with adrenal tumors.

摘要

引言

腹腔镜肾上腺切除术是治疗肾上腺肿瘤的首选技术。单孔腹腔镜手术(SILS)最近已引入该领域并应用于越南德医院。在此,我们报告我们单切口经腹肾上腺切除术的经验。

方法

2010年8月至2012年1月期间,我院61例患者(23例男性,38例女性)接受了SILS肾上腺切除术。诊断包括20例嗜铬细胞瘤患者,17例无功能腺瘤患者,16例原发性醛固酮增多症患者,4例库欣综合征患者和4例肾上腺囊肿患者。平均年龄为47.8岁(范围21 - 68岁)。有29例右侧肿瘤和32例左侧肿瘤;它们的平均直径为30.7毫米(范围8 - 59毫米)。患者取患侧在上的侧卧位。在脐水平做一个2.5厘米的直肠旁切口以插入SILS端口。

结果

平均手术时间为78分钟(范围50 - 120分钟),平均失血量约为70毫升。左侧肿瘤完全通过SILS技术切除。右侧病变有时需要额外的套管针(混合技术)。手术部位无需引流。无术中或术后并发症,但有1例转为传统三孔技术。平均住院时间为3.4天(范围2 - 6天)。

结论

我们的初步结果表明,SILS肾上腺切除术是安全的且在技术上可行。对于选定的肾上腺肿瘤患者,应将其纳入手术治疗方案中考虑。

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