[1]陈江英 许恩赐* 江玮 蔡伟忠 李梦强.腹腔镜巨大肾上腺肿瘤切除术18例报告[J].中国微创外科杂志,2015,15(10):910-916.
 Chen Jiangying,Xu Enci,Jiang Wei,et al.Laparoscopic Adrenalectomy for Large Adrenal Tumors: a Report of 18 Cases[J].Chinese Journal of Minimally Invasive Surgery,2015,15(10):910-916.
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腹腔镜巨大肾上腺肿瘤切除术18例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年10期
页码:
910-916
栏目:
临床研究
出版日期:
2015-10-20

文章信息/Info

Title:
Laparoscopic Adrenalectomy for Large Adrenal Tumors: a Report of 18 Cases
作者:
陈江英 许恩赐* 江玮 蔡伟忠 李梦强
(福建医科大学附属协和医院泌尿外科,福州350001)
Author(s):
Chen Jiangying Xu Enci Jiang Wei et al.
Department of Urology, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, China
关键词:
肾上腺肿瘤腹腔镜肾上腺切除术
Keywords:
Adrenal gland neoplasmLaparoscopyAdrenalectomyGagner
分类号:
R736.6
文献标志码:
A
摘要:
目的探讨腹腔镜手术切除巨大肾上腺肿瘤(直径>6 cm)的可行性及疗效。方法2007年10月~2014年6月我科行腹腔镜巨大肾上腺肿瘤切除术18例,其中6例肾上腺肿瘤直径<10 cm,偏向背侧生长,术前CT提示肿瘤边界清楚,与周围组织血管无明显浸润,采用经后腹膜腔入路,其余12例采用经腹腔入路。结果18例手术均获得成功,无中转开放手术。经后腹膜腔入路手术时间75~180 min,平均98 min;术中出血50~400 ml,平均200 ml。经腹腔入路手术时间90~210 min,平均116 min;术中出血50~1500 ml,平均275 ml,其中2例术中输血。18例术后随访3~60个月,平均30个月,1例术前有高血压术后仍有高血压,但单服钙离子拮抗剂血压可控制,余术前有高血压者术后血压均恢复正常;复查B超或CT均未见肿瘤复发、转移。结论对于经验丰富且技术娴熟的外科医生,腹腔镜巨大肾上腺肿瘤切除术是安全、有效的。
Abstract:
ObjectiveTo evaluate the feasibility and clinical effect of laparoscopic adrenalectomy for large adrenal tumors (> 6 cm in diameter).MethodsBetween October 2007 and June 2014, 18 patients with large adrenal tumors underwent laparoscopic adrenalectomy in our hospital, including 6 retroperitoneal approach surgery and 12 transperitoneal approach surgery.ResultsThe laparoscopic adrenalectomy was performed successfully in all the 18 patients, without conversion to open surgery. In the retroperitoneal approach group, the operating time was 75-180 min (mean, 98 min), and the blood loss was 50-400 ml (mean, 200 ml). In the transperitoneal approach group, the operating time was 90-210 min (mean, 116 min), and the blood loss was 50-1500 ml (mean, 275 ml), including 2 patients receiving blood transfusion. During 3-60 months of follow-up in the 18 patients, the patients with high blood pressure became normal except one. No recurrence or metastasis was found.ConclusionIt is safe and effective for skilled surgeons to perform laparoscopic operation for large adrenal tumors.

参考文献/References:

[1]Gagner M,Lacroix A,Bolte E.Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma.N Engl J Med,1992,327(14):1033.
[2]Imai T.Surgery of the adrenal gland.Nihon Geka Gakkai Zasshi,2012,113(6):496-501.
[3]Gaujoux S,Bonnet S,Leconte M,et al.Risk factors for conversion and complications after unilateral laparoscopic adrenalectomy.Br J Surg,2011,98(10):1392-1399.
[4]卢剑,黄毅,洪锴,等.后腹腔镜较大肾上腺肿瘤切除的探讨.北京大学学报(医学版),2010,42(4):454-457.
[5]Zografos G,Farfaras A,Vasiliadis G,et al.Laparoscopic resection of large adrenal tumors.JSLS,2010,14(3):364-368.
[6]徐旻,张大宏,李志江,等.腹腔镜手术治疗巨大肾上腺嗜铬细胞瘤(附6例报告).中国微创外科杂志,2010,10(4):337-338.
[7]Lee CR,Walz MK,Park S, et al.A comparative study of the transperitonea1 and posterior retroperitoneal approaches for laparoscopic adrenalectomy for adrenal tumors.Ann Surg Oncol,2012,19(8):2629-2634.
[8]Greco F,Hoda MR,Rassweiler J,et al.Laparoscopic adrenalectomy in urological centres-the experience of the German Laparoscopic Working Group.BJU Int,2O11,108(10):1646-1651.
[9]姜元军,孙志熙,宫大鑫,等.静止型嗜铬细胞瘤与非静止型嗜铬细胞瘤的比较.临床泌尿外科杂志,2003,18(4):212-213.
[10]Perry KA, Ei Youssef R,Pham TH,et al.Laparoscopic adrenalectomy for large unilateral pheochromocytoma:experience in a large academic medical center.Surg Endosc,2010,24(6):1462-1467.
[11]Zhang Xu,Lang Bin,Ouyang JZ,et al.Retreperitoneoscopic adrenalectomy without previous control of adrenal vein is feasible and safe for pheoehromocytoma.Urology,2007,69(5):849-853.

备注/Memo

备注/Memo:
*通讯作者,E-mail:xuenci0531@163.com
更新日期/Last Update: 2016-02-03