Simon D, Goretzki P E, Röher H D
Klinik für Allgemeine und Unfallchirurgie, Heinrich-Heinc-Universität Düsseldorf.
Zentralbl Chir. 1997;122(6):473-6.
The increasing detection rate of incidentalomas imposes not only the question about the necessity of treatment but also with introduction of laparoscopic adrenalectomy the question about operative strategy. Own patients and literature are analysed and discussed.
Between 1985 and 1996 203 patients have been operated on for adrenal disease including 21 patients with incidentaloma.
Biochemical analysis revealed latent hormonal activity in 9 patients. All patients were operated conventionally. Pathohistology demonstrated 1 adrenal carcinoma, 9 adrenocortical adenomas, 2 myelolipomas, 2 adrenal cysts, 2 nodular hyperplasias and 5 pheochromocytomas. Postoperative morbidity was 5% and mortality 0%.
Small and hormonally latent active tumors can be operated laparoscopically or conventionally via dorsal approach. In case of suspected malignancy conventional operation is the more reliable procedure.
偶然瘤检出率的不断上升不仅引发了关于治疗必要性的问题，随着腹腔镜肾上腺切除术的引入，还引发了关于手术策略的问题。对我们自己的患者及文献进行了分析和讨论。
1985年至1996年间，203例患者接受了肾上腺疾病手术，其中21例为偶然瘤患者。
生化分析显示9例患者存在潜在激素活性。所有患者均采用传统手术方式。病理组织学检查显示1例肾上腺皮质癌、9例肾上腺皮质腺瘤、2例肾上腺髓质脂肪瘤、2例肾上腺囊肿、2例结节性增生和5例嗜铬细胞瘤。术后发病率为5%，死亡率为0%。
小型且激素活性潜在的肿瘤可通过腹腔镜或经背部入路的传统手术方式进行切除。对于疑似恶性肿瘤的情况，传统手术是更可靠的方法。
