Möbius E, Nies C, Rothmund M
Department of General Surgery, Philipps-University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
Surg Endosc. 1999 Jan;13(1):35-9. doi: 10.1007/s004649900893.
The use of minimally invasive techniques in the surgical treatment of pheochromocytoma is controversial because of possible intraoperative excessive hormone release resulting in cardiovascular instabilities.
Laparoscopic adrenalectomy was performed in nine patients with a total of 10 pheochromocytomas. Conversion was required in two cases. The relevant data were prospectively documented and compared with a historical group of nine patients who had undergone conventional transabdominal adrenalectomy for unilateral pheochromocytoma.
The laparoscopic operations lasted significantly longer than the conventional procedures (median 243 min vs. 100 min, p < 0.01). Intraoperative cardiovascular instabilities (tachycardia, hypertension) occurred in seven laparoscopically and eight conventionally treated patients. All were easily controlled. Blood transfusions were necessary in four patients in the conventional and one patient in the laparoscopic group. Postoperative hospital stay and duration of analgetic treatment were significantly shorter after laparoscopic adrenalectomy.
Laparoscopic adrenalectomy is a safe procedure for patients with pheochromocytoma.
由于在手术治疗嗜铬细胞瘤时可能出现术中激素过度释放导致心血管不稳定，因此微创技术在嗜铬细胞瘤手术治疗中的应用存在争议。
对9例共10个嗜铬细胞瘤患者实施了腹腔镜肾上腺切除术。2例需要中转手术。前瞻性记录相关数据，并与一组9例因单侧嗜铬细胞瘤接受传统经腹肾上腺切除术的患者进行比较。
腹腔镜手术持续时间明显长于传统手术（中位时间243分钟对100分钟，p<0.01）。7例接受腹腔镜手术和8例接受传统手术的患者术中出现心血管不稳定（心动过速、高血压）。所有情况均易于控制。传统手术组4例患者和腹腔镜手术组1例患者需要输血。腹腔镜肾上腺切除术后的住院时间和镇痛治疗时间明显缩短。
腹腔镜肾上腺切除术对嗜铬细胞瘤患者是一种安全的手术方法。
