Pędziwiatr Michał, Matłok Maciej, Kulawik Jan, Major Piotr, Budzyński Piotr, Zub-Pokrowiecka Anna, Budzyński Andrzej
2 Department of Surgery, Medical College, Jagiellonian University, Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2013 Jun;8(2):146-51. doi: 10.5114/wiitm.2011.32942. Epub 2013 Jan 21.
Even the half of patients undergoing laparoscopic adrenalectomy has history of previous abdominal surgeries. However, it is still uncertain if this fact has an impact on the operation itself as well as the postoperative course.
To analyze the effects of previous abdominal surgery on surgical outcomes in adrenal tumor patients subjected to laparoscopic adrenalectomy.
This study included 268 patients with adrenal gland tumors operated on by means of laparoscopic lateral transperitoneal adrenalectomy: 1) previously subjected to at least one abdominal surgery (group A, n = 101), or 2) with no history of previous abdominal operations (group B, n = 167).
Groups A and B did not differ in terms of tumor size (p = 0.132), mean operation time (p = 0.456), mean intraoperative blood loss (p = 0.754), or perioperative complication rate (p = 0.833). Dissection of intraperitoneal adhesions was considered difficult in 32 patients from group A (31.6%) and 8 subjects from group B (4.7%, p < 0.001). Conversion was required in three subjects from group A (2.9%) and 3 patients from group B (1.8%, p = 0.529).
Previous abdominal surgery does not constitute a contraindication to laparoscopic transperitoneal adrenalectomy.
即使是接受腹腔镜肾上腺切除术的患者中，也有一半曾有过腹部手术史。然而，这一事实是否会对手术本身以及术后病程产生影响仍不确定。
分析既往腹部手术对接受腹腔镜肾上腺切除术的肾上腺肿瘤患者手术结局的影响。
本研究纳入了268例行腹腔镜经腹外侧肾上腺切除术的肾上腺肿瘤患者：1）既往至少接受过一次腹部手术（A组，n = 101），或2）无既往腹部手术史（B组，n = 167）。
A组和B组在肿瘤大小（p = 0.132）、平均手术时间（p = 0.456）、平均术中出血量（p = 0.754）或围手术期并发症发生率（p = 0.833）方面无差异。A组32例患者（31.6%）和B组8例患者（4.7%，p < 0.001）的腹腔粘连分离被认为困难。A组3例患者（2.9%）和B组3例患者（1.8%，p = 0.529）需要中转手术。
既往腹部手术并非腹腔镜经腹肾上腺切除术的禁忌证。
