Tan Qi, Lin Fan, He Yunfeng, Luo Shengjun
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road,Yuzhong District, Chongqing, 400016, China.
BMC Urol. 2025 Apr 3;25(1):72. doi: 10.1186/s12894-025-01762-2.
To investigate the safety and effectiveness of retroperitoneal adrenalectomy via extra and intra perinephric fat approaches to provide experience and basis for resection of adrenal tumors through the retroperitoneal cavity.
The clinical data of 284 patients undergoing retroperitoneal adrenalectomy in our hospital from December 2017 to March 2023 were collected. The basic characteristics of the two groups of patients and the changes in perioperative indicators were retrospectively analyzed.
A total of 117 patients with intra perinephric fat approach (IPFA) were included,and 167 patients with extra perinephric fat approach (EPFA) were included. The estimated blood loss in the IPFA group (123.59 ± 50.76 ml) was higher than that in the EPFA group (99.10 ± 99.51 ml) (p = 0.015),and the operative time in the IPFA group(105.25 ± 42.25 min) was longer than that in the EPFA group(81.75 ± 30.45 min) (p < 0.001).The hospitalization expenses of IPFA patients (36,306.39 ± 7544.25RMB) were higher compared with patients receiving EPFA (32,122.77 ± 7284.00RMB) (p < 0.001).There were no significant differences between the two groups in terms of tumor size,blood transfusion times and postoperative hospitalization time.
Retroperitoneal laparoscopic adrenalectomy is a safe and effective procedure that can be performed via extra and intra perinephric fat approaches.IPFA is associated with higher estimated blood loss, and the operation time of EPFA is shorter than IPFA. The choice of surgical approach may depend primarily on the experience of the surgeon, the characteristics of adrenal tumor, and the nature of perirenal adipose tissue.
探讨经肾周脂肪内外途径后腹腔镜肾上腺切除术的安全性和有效性，为经后腹腔行肾上腺肿瘤切除术提供经验和依据。
收集2017年12月至2023年3月在我院行后腹腔镜肾上腺切除术的284例患者的临床资料。回顾性分析两组患者的基本特征及围手术期指标变化。
共纳入117例经肾周脂肪内途径（IPFA）患者和167例经肾周脂肪外途径（EPFA）患者。IPFA组估计失血量（123.59±50.76 ml）高于EPFA组（99.10±99.51 ml）（p = 0.015），IPFA组手术时间（105.25±42.25 min）长于EPFA组（81.75±30.45 min）（p < 0.001）。IPFA患者住院费用（36306.39±7544.25元人民币）高于EPFA患者（32122.77±7284.00元人民币）（p < 0.001）。两组在肿瘤大小、输血次数和术后住院时间方面无显著差异。
后腹腔镜肾上腺切除术是一种安全有效的手术，可经肾周脂肪内外途径进行。IPFA估计失血量较高，EPFA手术时间短于IPFA。手术方式的选择可能主要取决于术者经验、肾上腺肿瘤特征及肾周脂肪组织性质。
