Han Jeong Hee, Lee Byoung Chul, Park Young Mok, Jung Hyuk Jae, Kim Dong-Il, Choi Jung Bum
Department of Surgery, Pusan National University Hospital, Busan, Korea.
Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Clin Oncol. 2021 Dec;17(2):90-95. doi: 10.14216/kjco.21014. Epub 2021 Dec 31.
Laparoscopic posterior retroperitoneal adrenalectomy (LPRA) is a surgical method that accesses the adrenal gland through the back. The aim of this study was to report initial experience of LPRA and evaluate possibilities for surgical application.
From March 2018 to December 2019, a total of 30 consecutive patients diagnosed with adrenal tumor underwent surgical treatment at Pusan National University Hospital were enrolled. Clinicopathologic features and various peri- and postoperative parameters were analyzed by retrospective medical record review. The mean age of the patients was 48.20±13.66 years.
The mean body mass index (BMI) was 25.50±4.30 kg/m. Primary hyperaldosteronism was the most frequently preoperative diagnosed disease (n=13, 43.4%), followed by adrenal incidentaloma (n=8, 26.6%), Cushing syndrome (n=5, 16.6%) and pheochromocytoma (n=4, 13.3%). The mean size of postoperative adrenal tumor was 2.72±1.76 cm. The mean operating time was 162±58.14 minutes. Among the 30 patients, 28 patients underwent total adrenalectomy (93.3%) and two patients underwent cortical sparing adrenalectomy (6.7%). When LPRA was performed for patients with BMI >23.16 kg/m, the operating time was longer than the average (P=0.016).
LPRA was suitable and safe for patients with benign adrenal tumors. BMI, retroperitoneal fat density and postoperative adrenal weight may be related to the operating time, so they should be considered when deciding on a surgical method for adrenalectomy.
腹腔镜后腹膜肾上腺切除术（LPRA）是一种经背部入路切除肾上腺的手术方法。本研究旨在报告LPRA的初步经验并评估其手术应用的可能性。
选取2018年3月至2019年12月在釜山国立大学医院连续接受手术治疗的30例肾上腺肿瘤患者。通过回顾性病历审查分析临床病理特征及各种围手术期和术后参数。患者的平均年龄为48.20±13.66岁。
平均体重指数（BMI）为25.50±4.30kg/m²。原发性醛固酮增多症是术前最常诊断的疾病（n=13，43.4%），其次是肾上腺偶发瘤（n=8，26.6%）、库欣综合征（n=5，16.6%）和嗜铬细胞瘤（n=4，13.3%）。术后肾上腺肿瘤的平均大小为2.72±1.76cm。平均手术时间为162±58.14分钟。30例患者中，28例行肾上腺全切术（93.3%），2例行保留肾上腺皮质切除术（6.7%）。当对BMI>23.16kg/m²的患者进行LPRA时，手术时间长于平均水平（P=0.016）。
LPRA对肾上腺良性肿瘤患者是合适且安全的。BMI（体重指数）、腹膜后脂肪密度和术后肾上腺重量可能与手术时间有关，因此在决定肾上腺切除术的手术方式时应予以考虑。
