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手辅助腹腔镜肾上腺切除术与腹腔镜肾上腺切除术治疗大嗜铬细胞瘤的比较：一项回顾性研究。

Comparison of hand-assisted laparoscopic adrenalectomy laparoscopic adrenalectomy for large pheochromocytomas: a retrospective study.

作者信息

Sun Qihao, Liu Yuxin, Long Houtao, Zhang Daofeng, Li Haorui, Sun Xiaoliang, Zhao Yong, Zhang Haiyang

机构信息

Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, China.

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Gland Surg. 2024 Dec 31;13(12):2348-2358. doi: 10.21037/gs-24-407. Epub 2024 Dec 27.

DOI:10.21037/gs-24-407
PMID:39822367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11733643/
Abstract

BACKGROUND

It remains uncertain whether hand-assisted laparoscopic adrenalectomy (HAL) has advantages in treating large pheochromocytomas (PHEOs). This study aimed to assess the feasibility and safety of HAL compared to laparoscopic adrenalectomy (LA).

METHODS

We conducted a retrospective study on patients with PHEOs ≥6 cm who received HAL (n=16) and LA (n=20) at Shandong Provincial Hospital from January 2020 to January 2023. The two groups were balanced into 8 pairs using propensity score matching (PSM). Perioperative parameters and long-term follow-up outcomes were compared between the two groups.

RESULTS

After adjusting for balance through PSM, patients in the HAL group had shorter operation time (105.00±18.52 147.50±7.07 minutes, P<0.001), faster bowel recovery days (1.0 2.0 days, P=0.043), and shorter postoperative hospital stays (5.00 7.50 days, P=0.01). The differences in blood pressure improvement within 3 months postoperatively, and recurrence and metastasis between the two groups (75.00% 62.50%, P>0.99; 12.50% 12.50%, P>0.99) were not statistically significant.

CONCLUSIONS

This study suggested that HAL was feasible and safe for patients with large PHEOs. Both HAL and LA showed comparable perioperative and long-term follow-up results.

摘要

背景

手辅助腹腔镜肾上腺切除术（HAL）在治疗大型嗜铬细胞瘤（PHEO）方面是否具有优势尚不确定。本研究旨在评估HAL与腹腔镜肾上腺切除术（LA）相比的可行性和安全性。

方法

我们对2020年1月至2023年1月在山东省立医院接受HAL（n = 16）和LA（n = 20）治疗的PHEO≥6 cm患者进行了一项回顾性研究。使用倾向得分匹配（PSM）将两组均衡为8对。比较两组的围手术期参数和长期随访结果。

结果

通过PSM调整平衡后，HAL组患者的手术时间较短（105.00±18.52对147.50±7.07分钟，P<0.001），肠道恢复天数更快（1.0对2.0天，P = 0.043），术后住院时间更短（5.00对7.50天，P = 0.01）。两组术后3个月内血压改善情况以及复发和转移情况的差异（75.00%对62.50%，P>0.99；12.50%对12.50%，P>0.99）无统计学意义。

结论

本研究表明，HAL对大型PHEO患者是可行且安全的。HAL和LA在围手术期和长期随访结果方面表现相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/d3a93fe5eef2/gs-13-12-2348-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/d924914ebc5c/gs-13-12-2348-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/cfc8fdb3fdbd/gs-13-12-2348-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/b083440f11f2/gs-13-12-2348-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/d3a93fe5eef2/gs-13-12-2348-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/d924914ebc5c/gs-13-12-2348-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/cfc8fdb3fdbd/gs-13-12-2348-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/b083440f11f2/gs-13-12-2348-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36d2/11733643/d3a93fe5eef2/gs-13-12-2348-f4.jpg

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In Vivo. 2024 Nov-Dec;38(6):2836-2843. doi: 10.21873/invivo.13764.
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Identification of risk factors for postoperative persistent hypertension in patients with pheochromocytoma.识别嗜铬细胞瘤患者术后持续性高血压的风险因素。
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