Mayhew Philipp D, Culp William T N, Hunt Geraldine B, Steffey Michele A, Mayhew Kelli N, Fuller Mark, Della-Maggiore Ann, Nelson Richard W
Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616., Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
J Am Vet Med Assoc. 2014 Nov 1;245(9):1028-35. doi: 10.2460/javma.245.9.1028.
To describe the clinicopathologic features of a cohort of dogs with adrenocortical masses that underwent laparoscopic adrenalectomy and to compare perioperative morbidity and mortality rates in these dogs with rates for dogs that underwent open adrenalectomy for resection of similarly sized (maximal diameter, ≤ 5 cm) adrenocortical masses.
Retrospective case series.
48 client-owned dogs that underwent laparoscopic (n = 23) or open (25) adrenalectomy for noninvasive tumors (ie, tumors that did not invade the vena cava or other surrounding organs). Procedures-Medical records were reviewed. History, clinical signs, physical examination findings, clinicopathologic findings, imaging results, and surgical variables were recorded. A 3- or 4-port approach was used for laparoscopic adrenalectomy. Surgical time, perioperative complications, postoperative and overall hospitalization times, and perioperative deaths were recorded and compared between groups.
The surgical method for 1 dog was converted from a laparoscopic to an open approach. Perioperative death occurred in no dogs in the laparoscopic group and 2 dogs in the open adrenalectomy group. Surgical time was shorter for laparoscopic (median, 90 minutes; range, 40 to 150 minutes) than for open (median, 120 minutes; range, 75 to 195 minutes) adrenalectomy. Laparoscopic adrenalectomy was associated with shorter hospitalization time and more rapid discharge from the hospital after surgery, compared with the open procedure.
With careful patient selection, laparoscopic adrenalectomy was associated with a low complication rate and low conversion rate for resection of adrenocortical masses as well as shorter surgical and hospitalization times, compared with open adrenalectomy.
描述一组接受腹腔镜肾上腺切除术的患有肾上腺皮质肿块的犬的临床病理特征，并将这些犬的围手术期发病率和死亡率与因切除大小相似（最大直径≤5 cm）的肾上腺皮质肿块而接受开放性肾上腺切除术的犬的发病率和死亡率进行比较。
回顾性病例系列。
48只客户拥有的犬，它们因非侵袭性肿瘤（即未侵犯腔静脉或其他周围器官的肿瘤）接受了腹腔镜（n = 23）或开放性（25）肾上腺切除术。程序——查阅病历。记录病史、临床症状、体格检查结果、临床病理结果、影像学结果和手术变量。采用三孔或四孔法进行腹腔镜肾上腺切除术。记录并比较两组的手术时间、围手术期并发症、术后和总体住院时间以及围手术期死亡情况。
1只犬的手术方法从腹腔镜手术转为开放手术。腹腔镜组无犬发生围手术期死亡，开放性肾上腺切除术组有2只犬死亡。腹腔镜肾上腺切除术的手术时间（中位数，90分钟；范围，40至150分钟）比开放性肾上腺切除术（中位数，120分钟；范围，75至195分钟）短。与开放手术相比，腹腔镜肾上腺切除术与更短的住院时间和术后更快出院相关。
经过仔细的患者选择，与开放性肾上腺切除术相比，腹腔镜肾上腺切除术在切除肾上腺皮质肿块时并发症发生率低、转换率低，且手术和住院时间更短。
