Ayhan Erdemir, Rasa Kemal Hüseyin
Department of General Surgery, Anadolu Medical Center Hospital, Kocaeli, Turkey.
J Minim Access Surg. 2023 Apr-Jun;19(2):212-216. doi: 10.4103/jmas.jmas_115_22.
Laparoscopic adrenalectomy is currently considered the gold standard method for adrenal surgery. Open surgery is the most frequent technique preferred amongst surgeons who are faced with tumours of larger sizes or challenging lesions. Despite the increasing interest in laparoscopy, most centres still utilise open surgery for challenging adrenal cases.
We retrospectively evaluated our successive 30 robotic adrenalectomies performed in the past 10 years and assigned the patients into 'difficult' and 'easy' groups. Patients with malignant tumours or tumour size of over 8 cm were assigned to the 'difficult group' and others to the 'easy group'. Groups were evaluated according to the demographic features of the patients, side of the operation, the body mass index (BMI) and laparotomy history. The duration of anaesthesia, amount of bleeding during surgery and the hospitalisation periods were also evaluated.
There is no statistically significant difference between the two groups considering age, gender, BMI value, operation side, presence or absence of a laparotomy history, the amount of bleeding during the operation and hospitalisation duration (P > 0.05). The anaesthesia duration was found to be higher in the 'difficult' patient group (P < 0.05).
Our results present robust evidence to support the idea that robotic adrenalectomy is not only a doable but also a safe option for malignant and large adrenal masses.
腹腔镜肾上腺切除术目前被认为是肾上腺手术的金标准方法。开放手术是面对较大肿瘤或具有挑战性病变的外科医生最常选择的技术。尽管对腹腔镜手术的兴趣日益增加，但大多数中心在处理具有挑战性的肾上腺病例时仍采用开放手术。
我们回顾性评估了过去10年中连续进行的30例机器人肾上腺切除术，并将患者分为“困难”组和“容易”组。患有恶性肿瘤或肿瘤大小超过8 cm的患者被分配到“困难”组，其他患者被分配到“容易”组。根据患者的人口统计学特征、手术侧别、体重指数（BMI）和剖腹手术史对两组进行评估。还评估了麻醉持续时间、手术期间的出血量和住院时间。
在年龄、性别、BMI值、手术侧别、是否有剖腹手术史、手术期间出血量和住院时间方面，两组之间没有统计学上的显著差异（P>0.05）。发现“困难”患者组的麻醉持续时间更长（P<0.05）。
我们的结果提供了有力证据，支持机器人肾上腺切除术不仅是一种可行的，而且是治疗恶性和大型肾上腺肿块的安全选择这一观点。
