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腹腔镜治疗肾上腺肿瘤:单中心58例患者的经验

Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients.

作者信息

Ari Aziz, Buyukasik Kenan, Tatar Cihad, Segmen Ozgur, Ersoz Feyzullah, Arikan Soykan, Gunver Feray, Sari Serkan

机构信息

Department of General Surgery, Istanbul Education and Research Hospital, Istanbul, Turkey.

Department of Pathology, Istanbul Education and Research Hospital, Istanbul, Turkey.

出版信息

Surg Res Pract. 2016;2016:9574391. doi: 10.1155/2016/9574391. Epub 2016 Nov 16.

Abstract

The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%. The size of the masses ranged from 1 up to 9 cm (mean 4,3 ± 1,5). Urine hormone excretion was measured within normal ranges in 47 out of 58 patients (81%). Most of the diagnosed patients were harboring Cortical Adenoma (: 38; 65,5%). All of the masses were successfully resected without complication except 3 patients. Because of complications of bleeding, the operation was converted to open surgery for 2 patients. Morbidity, mortality, and healing were comparable, regardless of tumor size, yet involvement in both laparoscopic and adrenal surgery was required. Our results suggested that laparoscopic adrenalectomy should replace open surgery as the standard treatment for most adrenal masses.

摘要

本研究旨在通过我院治疗的一系列病例,探讨腹腔镜手术方法,并评估肾上腺肿块中突触素、Ki-67和抑制素的免疫组化表达谱及患者预后。该研究对58例诊断为肾上腺肿块的患者进行。所有病例均接受了肾上腺肿块的腹腔镜手术。45例患者(77.6%)的抑制素和突触素均呈阳性。11例患者的Ki-67呈阴性,42例呈阳性,阳性率为1%。肿块大小从1厘米到9厘米不等(平均4.3±1.5厘米)。58例患者中有47例(81%)的尿激素排泄量在正常范围内。大多数确诊患者患有皮质腺瘤(38例;65.5%)。除3例患者外,所有肿块均成功切除且无并发症。由于出血并发症,2例患者的手术转为开放手术。无论肿瘤大小如何,发病率、死亡率和愈合情况均相当,但需要同时参与腹腔镜手术和肾上腺手术。我们的结果表明,腹腔镜肾上腺切除术应取代开放手术,成为大多数肾上腺肿块的标准治疗方法。

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