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腹腔镜肾上腺切除术中中心静脉隔离与无管化治疗的联合应用。

coupled use of central-vein isolation and tubeless treatment in laparoscopic adrenalectomy.

作者信息

Xu Baisheng, Leng FenGui, Fu Bin, Jiang Yanying, Wang Feng, Hu Jianmiao, Gao Hongbing, Leng Xu, Liao Caizhi

机构信息

The First Hospital of Xiushui, Jiujiang, Jiangxi Province 332400, PR China.

The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China.

出版信息

Surg Pract Sci. 2023 Apr 8;13:100164. doi: 10.1016/j.sipas.2023.100164. eCollection 2023 Jun.

Abstract

OBJECTIVE

To explore the combined uses of central vein isolation-based laparoscopic technique and tubeless cardiovascular interventional technique (CVIT) in laparoscopic adrenalectomy.

METHODS

31 subject patients with adrenal tumors were recruited and treated from January 2020 to November 2021. Regarding tumor size, the average transverse diameter of the adrenal tumor was (2.2 ± 1.0) cm and the average longitudinal diameter of the tumor was (3.1 ± 1.5) cm, respectively. All subject patients were operated on through the abdominal approach. The "central vein isolation" based laparoscopic technique was adopted to complete the operation. No drainage tube was placed in the patients. For this study, selected performance parameters, including the operation time, intraoperative bleeding, postoperative hospital stays, and postoperative complications were recorded and analyzed.

RESULTS

All the tumors were removed laparoscopically without any conversion to open surgery. All 31 recruited subjects were treated successfully with preservation of adrenocortical function. The mean operation time was 30 min (range from 25 to 63 min); the mean amount of intraoperative bleeding was approximately 3 mL (ranges from 0 to 10 mL); the mean postoperative hospital stay was 3 days (range from 2 to 6 days). Of note, no complications were recorded, such as adjacent organ injury, large vessel injury, infection, and secondary bleeding that occurred during and after the operation.

CONCLUSION

The combined use of central-vein isolation laparoscopic technique and tubeless treatment ensures a facile, safe, and robust laparoscopic adrenalectomy operation in clinical practice.

摘要

目的

探讨基于中央静脉分离的腹腔镜技术与无管心血管介入技术(CVIT)在腹腔镜肾上腺切除术中的联合应用。

方法

选取2020年1月至2021年11月间31例肾上腺肿瘤患者进行治疗。就肿瘤大小而言,肾上腺肿瘤的平均横径为(2.2±1.0)cm,平均纵径为(3.1±1.5)cm。所有受试患者均经腹部入路进行手术。采用基于“中央静脉分离”的腹腔镜技术完成手术。患者未放置引流管。本研究记录并分析了选定的性能参数,包括手术时间、术中出血、术后住院时间和术后并发症。

结果

所有肿瘤均通过腹腔镜切除,无一例转为开放手术。所有31例受试对象均成功治疗,肾上腺皮质功能得以保留。平均手术时间为30分钟(范围为25至63分钟);平均术中出血量约为3毫升(范围为0至10毫升);平均术后住院时间为3天(范围为2至6天)。值得注意的是,未记录到手术期间及术后发生的诸如邻近器官损伤、大血管损伤、感染和继发性出血等并发症。

结论

中央静脉分离腹腔镜技术与无管治疗的联合应用确保了临床实践中腹腔镜肾上腺切除术简便、安全且可靠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5075/11750033/6de07536101f/gr1.jpg

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