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肾上腺囊肿——最佳腹腔镜治疗方法

Adrenal cysts - optimal laparoscopic treatment.

作者信息

Pogorzelski Ryszard, Toutounchi Sadegh, Krajewska Ewa, Ambroziak Urszula, Koperski Łukasz, Wołoszko Tomasz, Celejewski Krzysztof, Szostek Małgorzata M, Jakuczun Wawrzyniec, Gałązka Zbigniew

机构信息

Department of General and Endocrine Surgery, Medical University of Warsaw, Warsaw, Poland.

Department of Endocrinology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2018 Sep;13(3):288-291. doi: 10.5114/wiitm.2018.75872. Epub 2018 May 21.

Abstract

INTRODUCTION

Adrenal cysts develop in up to about 0.2% of the overall population. They may account for up to 11% of all pathologies of adrenal glands.

AIM

Is laparoscopic resection of adrenal cysts a method for the treatment of these pathologies?

MATERIAL AND METHODS

In the years 2010-2017, a total of 27 patients underwent surgery due to adrenal cysts; those included 18 (66.7%) women and 9 (33.3%) men aged 29 to 84 years (mean age: 42.7). Cyst diameter ranged from 55 to 130 mm. After exclusion of hormonal hyperactivity, parasitic cysts, or, to the best possible extent, cancer lesions, patients were qualified for adrenal-sparing laparoscopic surgery.

RESULTS

All patients were subjected to laparoscopic surgery. Cystic wall resection was performed in 15 (55.6%) patients while adrenalectomy was performed in the remaining 12 (44.4%) patients. The decision regarding the extent of the surgery was made intraoperatively. Histopathological assessment revealed pathological adrenal lesions in as few as 3 (11.1%) patients, with the rest of the study population, i.e. 24 (88.9%), presenting with normal adrenal tissue.

CONCLUSIONS

Laparoscopic resection of adrenal cysts appears to be recommendable as a method for the treatment of these pathologies. It is simpler than adrenalectomy and associated with low risk of any pathological lesion remaining within the adrenal gland following careful intraoperative assessment by an experienced surgeon.

摘要

引言

肾上腺囊肿在总人口中的发生率高达约0.2%。它们可能占肾上腺所有病变的11%。

目的

肾上腺囊肿的腹腔镜切除术是否是治疗这些病变的一种方法?

材料与方法

2010年至2017年期间,共有27例因肾上腺囊肿接受手术的患者;其中包括18名(66.7%)女性和9名(33.3%)男性,年龄在29至84岁之间(平均年龄:42.7岁)。囊肿直径范围为55至130毫米。在排除激素活性亢进、寄生虫囊肿或尽可能排除癌性病变后,患者符合保留肾上腺的腹腔镜手术条件。

结果

所有患者均接受了腹腔镜手术。15例(55.6%)患者进行了囊肿壁切除术,其余12例(44.4%)患者进行了肾上腺切除术。手术范围的决定是在术中做出的。组织病理学评估显示,仅有3例(11.1%)患者存在病理性肾上腺病变,其余研究人群,即24例(88.9%),肾上腺组织正常。

结论

肾上腺囊肿的腹腔镜切除术似乎可作为治疗这些病变的一种推荐方法。它比肾上腺切除术更简单,并且在经验丰富的外科医生仔细的术中评估后,肾上腺内残留任何病理性病变的风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd19/6174168/253ba9124339/WIITM-13-32824-g001.jpg

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