Janetschek G, Altarac S, Finkenstedt G, Gasser R, Bartsch G
Department of Urology, University of Innsbruck, Austria.
Eur Urol. 1996;30(4):475-9. doi: 10.1159/000474218.
Our technique of laparoscopic adrenalectomy as well as the results of this method are presented.
Transperitoneal laparoscopic adrenalectomy was performed in 18 consecutive patients (10 right side, 8 left side) for Conn's disease (7 patients), pheochromocytoma (6 patients), Cushing's syndrome (1 patient), and large inactive adenoma (4 patients). The tumor size ranged between 1 and 8 cm (mean 4.2). One of the patients, who presented with Conn's disease and bilateral adenoma, underwent enucleation of the larger adenoma on the right side leaving the uninvolved portion of the adrenal gland intact.
The mean operative time was below 3 h; blood loss was minimal in all cases except 2. Hypertensive crisis was not encountered in this series. The only postoperative complication seen was transient diabetes insipidus which occurred in 1 patient. Analgesics were required only on the first 2 postoperative days. Oral intake and ambulation were resumed within 24 h. Mean postoperative hospitalization was 4.6 days.
In our hands, laparoscopic adrenalectomy proved to be associated with a low morbidity and few complications. In addition, it is one of the few procedures where laparoscopy can compete with open surgery in terms of operative time.
介绍我们的腹腔镜肾上腺切除术技术及该方法的结果。
对18例连续患者（右侧10例，左侧8例）进行经腹腹腔镜肾上腺切除术，治疗对象包括原发性醛固酮增多症（7例）、嗜铬细胞瘤（6例）、库欣综合征（1例）和大型无功能腺瘤（4例）。肿瘤大小在1至8厘米之间（平均4.2厘米）。其中1例原发性醛固酮增多症合并双侧腺瘤患者，对右侧较大腺瘤进行了剜除术，保留了肾上腺未受累部分。
平均手术时间低于3小时；除2例患者外，所有病例失血极少。本系列未发生高血压危象。仅1例患者出现术后短暂性尿崩症这一并发症。仅术后头2天需要使用镇痛药。术后24小时内恢复经口进食和下床活动。术后平均住院时间为4.6天。
在我们手中，腹腔镜肾上腺切除术被证明发病率低且并发症少。此外，它是少数在手术时间方面腹腔镜可与开放手术相媲美的手术之一。
