Hwang Insang, Jung Seung-Il, Yu Seong Hyeon, Hwang Eu Chang, Yu Ho Song, Kim Sun-Ouck, Kang Taek Won, Kwon Dong Deuk, Park Kwangsung
Department of Urology, Chonnam National University, 42, Jebongno, Donggu, Gwangju, 501-757, Republic of Korea.
World J Urol. 2014 Jun;32(3):723-8. doi: 10.1007/s00345-013-1139-7. Epub 2013 Aug 2.
To evaluate the surgical feasibility of retroperitoneal laparoscopic adrenalectomy for tumors exceeding 5 cm.
A retrospective review was carried out on all adrenalectomies performed between 2002 and 2011. All surgical procedures were performed or supervised by one of two experienced laparoscopic surgeons. A total of 133 patients who underwent retroperitoneal laparoscopic adrenalectomy were divided according to tumor size: group I (n = 57) had tumors <5 cm and group II (n = 76) had tumors ≥5 cm. The operative outcomes included surgical time, change in hemoglobin level, estimated blood loss, necessity for blood transfusion, time to ambulation, hospitalization duration, postoperative complications according to the Clavien-Dindo classification, and the rate of conversion to open surgery.
The estimated blood loss (271.75 ± 232.98 mL vs. 367.24 ± 275.11 mL; p = 0.037), time to ambulation (1.60 ± 0.49 days vs. 1.89 ± 0.31 days; p = 0.001), and postoperative hospitalization (7.88 ± 3.08 days vs. 9.264 ± 3.10 days; p = 0.012) were significantly higher in group II. The operation time and hemoglobin level change were not statistically different between groups. Blood transfusions were performed in 3 patients from group I and 6 patients from group II (5.3 vs. 7.9 %; p = 0.449). No patients experienced conversion to open surgery.
Retroperitoneal laparoscopic adrenalectomy can be used in patients with tumors larger than 5 cm.
评估后腹腔镜肾上腺切除术治疗直径超过5 cm肿瘤的手术可行性。
对2002年至2011年间施行的所有肾上腺切除术进行回顾性分析。所有手术均由两位经验丰富的腹腔镜外科医生之一实施或指导。将133例行后腹腔镜肾上腺切除术的患者按肿瘤大小分组：I组（n = 57）肿瘤直径<5 cm，II组（n = 76）肿瘤直径≥5 cm。手术结果包括手术时间、血红蛋白水平变化、估计失血量、输血必要性、下床活动时间、住院时间、根据Clavien-Dindo分类的术后并发症以及中转开放手术率。
II组的估计失血量（271.75 ± 232.98 mL对367.24 ± 275.11 mL；p = 0.037）、下床活动时间（1.60 ± 0.49天对1.89 ± 0.31天；p = 作者：0.001）和术后住院时间（7.88 ± 3.08天对9.264 ± 3.10天；p = 0.012）显著高于I组。两组间手术时间和血红蛋白水平变化无统计学差异。I组3例患者和II组6例患者接受了输血（5.3%对7.9%；p = 0.449）。无患者中转开放手术。
后腹腔镜肾上腺切除术可用于肿瘤直径大于5 cm的患者。
