Department of Urology, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan; Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taiwan.
J Formos Med Assoc. 2019 Jan;118(1 Pt 3):401-405. doi: 10.1016/j.jfma.2018.06.019. Epub 2018 Jul 11.
BACKGROUND/PURPOSE: This study aims to investigate the safety and feasibility of laparoscopic adrenalectomy for benign adrenal tumor without peri-operative NGT decompression.
From July 2010 to March 2014, 82 consecutive patients with benign unilateral adrenal tumor underwent elective laparoscopic adrenalectomy by a single surgeon were recruited for this study. We compared the clinico-demographic profile, estimated blood loss, operative time, time to full diet, time to ambulate, the length of hospital staying, analgesics use and complications between two groups stratified by the use of NGT.
There were no significant differences in the clinico-demographic profile of the two groups, including age, laterality, body mass index, gender, ASA classification, tumor diameter and histologic types between two groups. Peri-operative parameters were similar between NGT and Non-NGT groups (estimated blood loss, 55.85 vs. 54.4 ml; operative time, 110.3 vs. 112.3 min; p > 0.05) The post-operative outcome of interests, including days to full oral intake (3.32 vs. 3.34 days), days to ambulate (2.07 vs. 2.10 days), hospital stay (4.32 vs. 4.34 days), and analgesics use (6.00 vs. 5.83 mg; all p > 0.05) showed no significant difference between NGT and non-NGT group.
Laparoscopic adrenalectomy in patients with benign unilateral adrenal tumor without the use of peri-operative nasogastric tube decompression is safe and feasible.
背景/目的：本研究旨在探讨无围手术期鼻胃管减压的腹腔镜肾上腺切除术治疗良性肾上腺肿瘤的安全性和可行性。
自 2010 年 7 月至 2014 年 3 月，由同一位外科医生对 82 例连续单侧良性肾上腺肿瘤患者进行了择期腹腔镜肾上腺切除术。我们比较了两组患者的临床资料，包括年龄、性别、ASA 分级、肿瘤直径、肿瘤病理类型、术中失血量、手术时间、术后开始全流食时间、术后下床活动时间、术后住院时间、镇痛药使用情况和并发症。
两组患者的临床资料，包括年龄、肿瘤侧别、BMI、性别、ASA 分级、肿瘤直径、肿瘤病理类型差异均无统计学意义。NGT 组和非 NGT 组患者的围手术期参数相似（术中失血量分别为 55.85ml 和 54.4ml；手术时间分别为 110.3min 和 112.3min；P＞0.05）。术后第 3 天患者可经口正常进食（分别为 3.32 天和 3.34 天）、术后第 2 天可下床活动（分别为 2.07 天和 2.10 天）、术后住院时间（分别为 4.32 天和 4.34 天）、镇痛药使用量（分别为 6.00mg 和 5.83mg；P＞0.05）均无统计学差异。
在无围手术期鼻胃管减压的情况下，腹腔镜肾上腺切除术治疗良性单侧肾上腺肿瘤是安全可行的。
