Hotu Cheri, Harman Richard, Cutfield Richard, Hodges Nicola, Taylor Eletha, Young Simon
Department of Medicine, Waitemata District Health Board, Private Bag 93503, Takapuna, North Shore City 0740, New Zealand.
N Z Med J. 2015 Oct 16;128(1423):35-41.
To describe our 13-year experience in laparoscopic adrenalectomy for phaeochromocytoma.
We performed a retrospective analysis of case notes of 29 patients who underwent laparoscopic adrenalectomy for phaeochromocytoma between 2000 and 2013.
Twenty-nine patients (16 female), aged 16 to 67 years, underwent laparoscopic adrenalectomy for phaeochromocytoma. All patients were treated preoperatively with alpha-blocking agents. 80% were prescribed additional preoperative antihypertensive agents. 90% received antihypertensive agents intraoperatively. All patients received intraoperative magnesium sulphate for haemodynamic stabilisation. The mean operative time was 160 minutes. Nearly all of the patients experienced haemodynamic stability during surgery. Two patients required conversion to open adrenalectomy, due to severe intraoperative hypertension during tumour handling, and due to extensive intra-abdominal adhesions. Postoperative complications were minimal, and included blood loss, superior epigastric artery damage, and cellulitis at the laparoscopic port site. There was no perioperative mortality. The median length of stay postoperatively was 4 days. 24% were prescribed antihypertensive medication on discharge.
In our experience, favourable perioperative outcomes were achieved, demonstrating that laparoscopic adrenalectomy for phaeochromocytoma is a safe and effective procedure in the setting of experienced and skilled surgical, anaesthetic and medical teams delivering the perioperative care.
描述我们13年来行腹腔镜肾上腺嗜铬细胞瘤切除术的经验。
我们对2000年至2013年间接受腹腔镜肾上腺嗜铬细胞瘤切除术的29例患者的病历进行了回顾性分析。
29例患者（16例女性），年龄16至67岁，接受了腹腔镜肾上腺嗜铬细胞瘤切除术。所有患者术前均接受α受体阻滞剂治疗。80%的患者术前还使用了其他降压药物。90%的患者术中接受了降压药物治疗。所有患者术中均使用硫酸镁以稳定血流动力学。平均手术时间为160分钟。几乎所有患者在手术过程中血流动力学稳定。2例患者因肿瘤处理过程中严重的术中高血压以及广泛的腹腔内粘连而需要转为开放性肾上腺切除术。术后并发症极少，包括失血、上腹壁动脉损伤和腹腔镜切口部位蜂窝织炎。无围手术期死亡。术后中位住院时间为4天。24%的患者出院时开具了降压药物。
根据我们的经验，围手术期取得了良好的效果，表明在经验丰富且技术熟练的手术、麻醉和医疗团队提供围手术期护理的情况下，腹腔镜肾上腺嗜铬细胞瘤切除术是一种安全有效的手术方法。
