[1]吴芝莹 刘承 张树栋 黄毅 刘磊* 马潞林*.机器人辅助腹腔镜治疗复杂嗜铬细胞瘤和副神经节瘤手术技巧及初步结果(附16例报道)[J].中国微创外科杂志,2022,01(10):783-787.
　Wu Zhiying,Liu Cheng,Zhang Shudong,et al.Surgical Techniques and Preliminary Results of Robotassisted Laparoscopic Treatment of Complex Pheochromocytoma and Paraganglioma: a Report of 16 Cases[J].Chinese Journal of Minimally Invasive Surgery,2022,01(10):783-787.
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机器人辅助腹腔镜治疗复杂嗜铬细胞瘤和副神经节瘤手术技巧及初步结果(附16例报道)()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年10期
页码:
783-787
栏目:
临床研究
出版日期:
2023-01-20

文章信息/Info

Title:
Surgical Techniques and Preliminary Results of Robotassisted Laparoscopic Treatment of Complex Pheochromocytoma and Paraganglioma: a Report of 16 Cases
作者:
吴芝莹 刘承 张树栋 黄毅 刘磊* 马潞林*
(北京大学第三医院泌尿外科，北京100191)
Author(s):
Wu Zhiying;  Liu Cheng;  Zhang Shudong;  et al.
Department of Urology, Peking University Third Hospital, Beijing 100191, China
关键词:
机器人; 复杂; 嗜铬细胞瘤; 副神经节瘤; 安全性
Keywords:
Robot; Complex; Pheochromocytoma; Paraganglioma; Safety
文献标志码:
A
摘要:
目的探讨机器人辅助腹腔镜治疗复杂嗜铬细胞瘤和副神经节瘤(pheochromocytoma and paraganglioma，PHEO/PGL)的手术技巧和安全性。方法回顾性分析2020年11月~2021年12月16例机器人辅助腹腔镜手术治疗复杂PHEO/PGL的临床资料。肾上腺嗜铬细胞瘤14例，腹膜后副神经节瘤1例，右肾门区副神经节瘤1例。肿瘤位于左侧7例，右侧8例，正中(主动脉与下腔静脉之间)1例。大体积(直径>6 cm)PHEO/PGL 6例，与下腔静脉关系密切的右侧PHEO/PGL 5例，二次手术的PHEO/PGL 5例。肿瘤直径(7.4±1.9)cm。术前血压均控制在正常范围内。均采用机器人辅助腹腔镜肿瘤切除术。结果14例手术顺利完成，1例因肿瘤巨大，粘连严重，游离下腔静脉及输尿管困难，中转开放手术，1例二次手术者术中发现肿瘤与周围脏器粘连严重，无法辨认肠系膜上动脉，仅做探查。中位手术时间116.5 (79~283)min，术中估计出血量200.0 (10~3800)ml，术后住院时间5.5 (4~16)d。16例均获随访，中位随访时间12(6~16)个月。1例带瘤生存者长期口服降压药，15例肿瘤切除者未见肿瘤复发或转移。结论复杂PHEO/PGL手术难度大，机器人辅助腹腔镜治疗复杂PHEO/PGL具有操作精细灵活、创伤小的优势，是一种安全有效的术式。
Abstract:
ObjectiveTo summarize surgical techniques of robotassisted laparoscopic treatment of complex pheochromocytoma and paraganglioma (PHEO/PGL), and to discuss their safety and effectiveness.MethodsClinical data of 16 cases of roboticassisted laparoscopic surgery for complex PHEO/PGL from November 2020 to December 2021 were retrospectively analyzed. There were 14 cases of adrenal pheochromocytoma, 1 case of retroperitoneal paraganglioma and 1 case of paraganglioma in the right hilar region. The tumor was located on the left side in 7 cases, on the right side in 8 cases, and medially (between the aorta and the inferior vena cava) in 1 case. There were 6 cases of large PHEO/PGL (> 6 cm in diameter), 5 cases of rightsided PHEO/PGL in close relationship with the inferior vena cava, and 5 cases of PHEO/PGL with secondary surgery. The tumor diameter was (74±1.9) cm and the blood pressure was controlled within normal limits before surgery. All were operated by roboticassisted laparoscopic tumor resection.ResultsThe robotassisted surgery was completed successfully in 14 cases. One case was converted to open surgery because of the difficulty in freeing the inferior vena cava and ureter due to the huge tumor and serious adhesions, and 1 case of the second operation was only explored because of intraoperative discovery of serious adhesions with surrounding organs and inability to identify the superior mesenteric artery. The median operative time was 116.5 min (range, 79-283 min), the estimated intraoperative bleeding was 200.0 ml (range, 10-3800 ml), and the postoperative hospital stay was 5.5 d (range, 4-16 d). All the 16 cases were followed up for a median of 12 months (range, 6-16 months). One case survived with tumors with longterm oral antihypertensive medication. No tumor recurrence or metastasis was observed in the other 15 resected cases.ConclusionRoboticassisted laparoscopic treatment of complex PHEO/PGL is a safe and effective procedure with advantages of delicate and flexible operation and minimal trauma.

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备注/Memo

备注/Memo:
*通讯作者，Email：malulin@medmail.com.cn
更新日期/Last Update: 2023-01-20