Manger T, Piatek S, Klose S, Kopf D, Kunz D, Lehnert H, Lippert H
Klinik für Chirurgie, Otto-von-Guericke-Universität Magdeburg.
Langenbecks Arch Chir. 1997;382(1):37-42.
Laparoscopic transperitoneal and endoscopic extraperitoneal adrenalectomy are two safe options in minimally invasive surgery associated with a very low morbidity. Comparative studies with the conventional access to the adrenal gland demonstrated the advantages of the endoscopic technique. The anterior transperitoneal approach yields a better exposure of the anatomic structures and allows the surgeon to orient himself more easily, while at the same time he may perform additional laparoscopic maneuvers. In two cases of bilateral pheochromocytoma a bilateral laparoscopic adrenalectomy was performed simultaneously by employing the transperitoneal approach. The duration of surgery was approximately 210 and 270 min, respectively, with an intraoperative blood loss of about 350 and 400 ml. There were no complications following this procedure. Already on the 1st postoperative day, the patients could be fully mobilized. Furthermore, immunological data obtained perioperatively support the minimal invasiveness of this technique.
腹腔镜经腹腔和内镜经腹膜外肾上腺切除术是微创手术中两种安全的选择，发病率极低。与传统肾上腺手术入路的比较研究显示了内镜技术的优势。经腹腔前路能更好地暴露解剖结构，使外科医生更容易定位，同时还可进行其他腹腔镜操作。在两例双侧嗜铬细胞瘤患者中，采用经腹腔入路同时进行了双侧腹腔镜肾上腺切除术。手术时间分别约为210分钟和270分钟，术中失血约350毫升和400毫升。术后无并发症发生。术后第1天患者即可完全活动。此外，围手术期获得的免疫学数据也支持了该技术的微创性。
