Tuncel Altuğ, Balcı Melih, Köseoğlu Ersin, Aslan Yılmaz, Güzel Özer, Keten Tanju, Berker Dilek, Göler Serdar, Atan Ali
Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
Turk J Urol. 2013 Dec;39(4):214-9. doi: 10.5152/tud.2013.056.
To present our laparoscopic surgery experience in the treatment of adrenal masses.
Between January 2008 and February 2013, a total of 35 patients (24 females, 11 males) underwent transperitoneal laparoscopic adrenalectomy to treat an adrenal mass. The patients underwent hormonal evaluation, chemical shift magnetic resonance imaging, or abdominal computed tomography. Twenty-seven patients (77.1%) had a hormone-active adrenal mass.
Eighteen right, 16 left, and one bilateral transperitoneal laparoscopic adrenalectomies were performed. The mean age and body mass index of the patients were 47.4 years and 26.6 kg/m(2), respectively. The mean adrenal mass size, operation time, estimated blood loss, and hospitalization duration were 41.9 mm, 94.7 min, 30 cc, and 2.4 days, respectively. No minor or major complications were observed perioperatively or postoperatively. In one patient (2.8%), the laparoscopic approach was converted to open surgery due to severe bradycardia resulting from chronic obstructive pulmonary disease. Histopathological examinations revealed adrenocortical hyperplasia in 23 (66%) patients, benign pheochromocytoma in 8 (22.8%) patients, and periadrenal paraganglioma, adrenocortical carcinoma, myeloid metaplasia, and myelolipoma in one (2.8%) patient for each entity.
Transperitoneal laparoscopic adrenalectomy is a safe and efficient minimally invasive treatment option with a low morbidity rate in the surgical treatment of adrenal masses.
介绍我们在肾上腺肿块治疗中进行腹腔镜手术的经验。
2008年1月至2013年2月，共有35例患者（24例女性，11例男性）接受经腹腹腔镜肾上腺切除术以治疗肾上腺肿块。患者接受了激素评估、化学位移磁共振成像或腹部计算机断层扫描。27例患者（77.1%）有激素活性肾上腺肿块。
进行了18例右侧、16例左侧和1例双侧经腹腹腔镜肾上腺切除术。患者的平均年龄和体重指数分别为47.4岁和26.6kg/m²。肾上腺肿块的平均大小、手术时间、估计失血量和住院时间分别为41.9mm、94.7分钟、30cc和2.4天。围手术期和术后均未观察到轻微或严重并发症。1例患者（2.8%）因慢性阻塞性肺疾病导致严重心动过缓，腹腔镜手术转为开放手术。组织病理学检查显示，23例（66%）患者为肾上腺皮质增生，8例（22.8%）患者为良性嗜铬细胞瘤，每种实体各有1例（2.8%）患者为肾上腺副神经节瘤、肾上腺皮质癌、髓样化生和肾上腺髓质脂肪瘤。
经腹腹腔镜肾上腺切除术是肾上腺肿块手术治疗中一种安全有效的微创治疗选择，发病率低。
