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腹腔镜与机器人肾上腺切除术治疗嗜铬细胞瘤患者的比较。

Laparoscopic versus robotic adrenalectomy in pheochromocytoma patients.

机构信息

Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

J Surg Oncol. 2022 Sep;126(3):460-464. doi: 10.1002/jso.26918. Epub 2022 May 14.

Abstract

BACKGROUND AND OBJECTIVES

Pheochromocytoma is a challenging tumor type requiring resection with a clear margin and an intact capsule to prevent recurrences. Our aim was to compare perioperative outcomes of laparoscopic adrenalectomy (LA) versus robotic adrenalectomy (RA) for pheochromocytoma.

METHODS

In an institutional review board-approved retrospective study, clinical parameters of patients who underwent LA versus RA at a single center were compared using Mann-Whitney U, χ , and survival analyses. Continuous data are expressed as median (interquartile range).

RESULTS

There was a total of 157 patients (RA: n = 87, LA: n = 70) analyzed. Estimated blood loss (36.3 [35.0] vs. 99.9 [65.0] cc, p = 0.020) and hospital stay (1.3 [0.0] vs. 2.2 [1.0] days, p = 0.010) were lower in robotic versus laparoscopic group, respectively. Disease-free and overall survival was similar between groups. The rate of conversion to open for tumors ≥5 cm was less in the robotic group (0% vs. 14%, respectively, p = 0.048).

CONCLUSION

In this study, long-term outcomes of LA and RA were similar, although adrenalectomies performed robotically were associated with less blood loss, shorter hospital stay, and a lower chance of conversion to open in the case of large tumors.

摘要

背景与目的

嗜铬细胞瘤是一种具有挑战性的肿瘤类型,需要进行明确的边缘切除和完整包膜切除,以防止复发。我们的目的是比较腹腔镜肾上腺切除术(LA)与机器人辅助肾上腺切除术(RA)治疗嗜铬细胞瘤的围手术期结果。

方法

在一项机构审查委员会批准的回顾性研究中,比较了在一家中心接受 LA 与 RA 的患者的临床参数,使用 Mann-Whitney U、 χ 2 和生存分析进行比较。连续数据表示为中位数(四分位距)。

结果

共分析了 157 例患者(RA:n = 87,LA:n = 70)。机器人组的估计出血量(36.3 [35.0] vs. 99.9 [65.0] cc,p = 0.020)和住院时间(1.3 [0.0] vs. 2.2 [1.0] 天,p = 0.010)均低于腹腔镜组。两组无病生存率和总生存率相似。机器人组肿瘤≥5 cm 转为开放的比例较低(分别为 0% vs. 14%,p = 0.048)。

结论

在这项研究中,LA 和 RA 的长期结果相似,尽管机器人辅助肾上腺切除术的出血量较少,住院时间较短,对于大型肿瘤,转为开放的几率较低。

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