Ting A C, Lo C Y, Lo C M
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, China.
Am J Surg. 1998 Jun;175(6):488-90. doi: 10.1016/s0002-9610(98)00081-6.
The pathologies and size of adrenal lesions removed through the open posterior and laparoscopic routes share remarkable similarities. This study aims at comparing the relative merits of these two approaches.
Patients with adrenal tumors operated on by posterior approach (n = 56) and transabdominal laparoscopic approach (n = 12) between January 1981 and May 1997 were retrospectively reviewed.
The two groups were comparable in terms of age, and the position, size, and weight of the tumor. The operative time of posterior adrenalectomy was significantly shorter than that of laparoscopic adrenalectomy (median 120 minutes versus 160 minutes), whereas laparoscopic adrenalectomy was associated with less parenteral analgesic requirement (median 0 mg versus 225 mg), a shorter hospital stay (median 3 days versus 5 days), and a shorter duration off work (median 11 days versus 26 days). The estimated blood loss was also significantly reduced in the laparoscopic group (median 50 mL versus 150 mL).
Laparoscopic adrenalectomy is replacing posterior adrenalectomy to become the procedure of choice for the majority of patients undergoing adrenalectomy.
通过开放后入路和腹腔镜入路切除的肾上腺病变的病理情况和大小有显著相似性。本研究旨在比较这两种方法的相对优点。
回顾性分析1981年1月至1997年5月间采用后入路（n = 56）和经腹腹腔镜入路（n = 12）进行肾上腺肿瘤手术的患者。
两组在年龄、肿瘤位置、大小和重量方面具有可比性。后入路肾上腺切除术的手术时间明显短于腹腔镜肾上腺切除术（中位数120分钟对160分钟），而腹腔镜肾上腺切除术所需的非肠道镇痛药较少（中位数0毫克对225毫克），住院时间较短（中位数3天对5天），休假时间较短（中位数11天对26天）。腹腔镜组的估计失血量也显著减少（中位数50毫升对150毫升）。
腹腔镜肾上腺切除术正在取代后入路肾上腺切除术，成为大多数接受肾上腺切除术患者的首选术式。
