Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
Department of Urology, Fujian Provincial Hospital, Fuzhou, Fujian, China.
Front Endocrinol (Lausanne). 2024 Mar 4;15:1342240. doi: 10.3389/fendo.2024.1342240. eCollection 2024.
The modified three-level technique for retroperitoneal laparoscopic adrenalectomy (RLA) has proven beneficial in the treatment of adrenal lesions in patients with BMI≥25 Kg/m. This paper aims to summarize our institution's seven-year experience using this technique for all patients with Adrenal Lesions ≤ 6cm.
Between January 2016 and December 2022. The patients underwent laparoscopic adrenal surgery were categorized into Zhang's technique (ZT) (Three-level Technique) group and modified technique (MT) group. The fundamental characteristics and perioperative data were analyzed, with statistical significance set at p<0.05.
In total, 731 patients were stratified into two groups: ZT (n=448) and MT (n=283). Statistically significant distinctions were not detected between the two groups regarding sex, BMI, tumor location, tumor size, tumor type, or American Society of Anesthesiologists (ASA) score (p>0.05). The MT group demonstrated superior outcomes compared to the ZT group in terms of operative time, estimated blood loss, drainage volume, diet recovery time, complication rates, and postoperative hospitalization duration (p<0.05). 17 (4.34%) in the ZT group required unplanned adrenalectomy, while there was none in MT group (P<0.05).
MT retroperitoneal laparoscopic adrenalectomy has demonstrated its benefits in the treatment of adrenal lesions across all patients with adrenal lesions ≤ 6cm, serving as a valuable point of reference for the surgical management of adrenal diseases.
We have made modifications to the classic retroperitoneal laparoscopic adrenalectomy and achieved superior surgical outcomes, resulting in a procedure known as modified retroperitoneal laparoscopic adrenalectomy. This technique is suitable for both obese individuals and the general population with adrenal lesions ≤ 6cm.
改良的后腹腔镜肾上腺切除术（RLA）三级技术已被证明对 BMI≥25 Kg/m 的肾上腺病变患者的治疗有益。本文旨在总结我院七年来对所有≤6cm 肾上腺病变患者采用该技术的经验。
2016 年 1 月至 2022 年 12 月，行腹腔镜肾上腺手术的患者分为 Zhang 技术（ZT）（三级技术）组和改良技术（MT）组。分析基本特征和围手术期数据，以 p<0.05 为统计学意义。
共 731 例患者分为两组：ZT（n=448）和 MT（n=283）。两组间性别、BMI、肿瘤位置、肿瘤大小、肿瘤类型或美国麻醉医师协会（ASA）评分无统计学差异（p>0.05）。MT 组的手术时间、估计出血量、引流量、饮食恢复时间、并发症发生率和术后住院时间均优于 ZT 组（p<0.05）。ZT 组有 17 例（4.34%）需要计划外肾上腺切除术，而 MT 组无此类情况（P<0.05）。
MT 后腹腔镜肾上腺切除术在治疗所有≤6cm 肾上腺病变患者中显示出优势，为肾上腺疾病的手术治疗提供了有价值的参考。
我们对经典的后腹腔镜肾上腺切除术进行了改良，取得了更好的手术效果，称之为改良后腹腔镜肾上腺切除术。这种技术适用于肥胖人群和一般人群，适用于≤6cm 的肾上腺病变。
