Department of Urology, Ankara Numune Research and Training Hospital, University of Health Sciences, Ankara, Turkey,
Department of Urology, Ankara Numune Research and Training Hospital, University of Health Sciences, Ankara, Turkey.
Urol Int. 2020;104(1-2):75-80. doi: 10.1159/000501216. Epub 2019 Jun 26.
To compare the surgical outcomes and clinical improvement 1 year after laparoscopic partial and total adrenalectomy for the treatment of patients with nonhereditary unilateral functional adrenal adenomas.
From March 2016 to January 2018, we performed 15 laparoscopic partial adrenalectomy (LPA; Group 1) and 25 laparoscopic total adrenalectomy (LTA; Group 2) procedures. The key points reside in adenoma identification, preservation of the remaining glandular parenchyma, and its blood supply with dissection in the space between the adenoma and the normal parenchyma. The operative and clinical outcomes were compered.
The mean age of the patients was 45.1 (17-69) years and the median follow-up was 15 (12-26) months. Operative time, blood loss, and hospital stay were similar between the groups. No major perioperative and postoperative complications occurred. After surgery, all patients had resolution of their symptoms, with no patient in Group 1 requiring steroid replacement. However, a patient in Group 2 required steroid replacement therapy. On postoperative imaging, no residual and recurrent mass was detected.
Our results showed that LPA is safe and feasible, and has similar therapeutic results compared with LTA in patients with a nonhereditary hormonally active unilateral adrenal mass. Furthermore, LPA can obviate the need for steroid replacement in these patients.
比较腹腔镜下部分和全部肾上腺切除术治疗非遗传性单侧功能性肾上腺腺瘤患者 1 年后的手术结果和临床改善情况。
我们于 2016 年 3 月至 2018 年 1 月进行了 15 例腹腔镜部分肾上腺切除术（LPA；1 组）和 25 例腹腔镜全肾上腺切除术（LTA；2 组）。手术的关键在于识别腺瘤、保留剩余腺体实质及其血供，并在腺瘤与正常组织之间的空间进行解剖。比较了手术和临床结果。
患者的平均年龄为 45.1（17-69）岁，中位随访时间为 15（12-26）个月。两组间的手术时间、出血量和住院时间相似。两组均未发生重大围手术期和术后并发症。手术后，所有患者的症状均得到缓解，1 组患者中无一人需要类固醇替代治疗。然而，2 组中有 1 名患者需要类固醇替代治疗。术后影像学检查未发现残留和复发病灶。
我们的结果表明，LPA 安全可行，在治疗非遗传性单侧功能性肾上腺肿块患者方面与 LTA 具有相似的疗效。此外，LPA 可以避免这些患者需要类固醇替代治疗。
