后腹腔镜肾上腺肿瘤切除术78例报告

目的探讨后腹腔镜肾上腺肿瘤切除术的价值。方法2003年3月～2008年5月对78例肾上腺肿瘤行后腹腔镜肾上腺切除术。腰部3个trocar穿刺入路,观察镜直接推移法建立后腹膜腔,用超声刀将肿瘤切除。结果78例手术均取得成功,未输血。手术时间45～180min,平均90min。术后24h拔除引流管,术后3～5d出院。1例有局部皮下气肿,术后自行吸收,未出现其他并发症。72例术后随访3～24个月,平均10个月,36例术后3个月内血压恢复正常,7例仍需口服降压药物,肿瘤局部无复发。结论后腹腔镜肾上腺切除术具有安全、有效、创伤小、术后恢复快、住院时间短等优点,是治疗肾上腺良性肿瘤的首选方法。

Retroperitoneal Laparoscopic Adrenalectomy in 78 Cases

Objective To evaluate the value of retroperitoneal laparoseopic adrenalectomy for benign adrenal tumors. Methods From March 2003 to May 2008, 78 patients with adrenal tumors received retroperitoneal laparoscopic adrenalectomy in our hospital. During the operation, three trocars were introduced into the lumbar region to establish retroperitoneal space by blunt dissection with the camera. Afterwards, the tumor was removed by using a harmonic scalpel. Results The procedures were successfully completed in all the 78 cases without blood transfusion, the operation time ranged from 45 to 180 min （mean, 90 min）. Drainage tubes were removed 24 hours after the operation. And the patients were discharged from hospital in 3 to 5 days postoperation. One patient showed regional subcutaneous emphysema after the surgery and was cured spontaneously. The patients were followed up for 3 to 24 months with a mean of 10 months, during which 36 patients achieved normal blood pressure in 3 months, while in the other 7 patients, oral antihypertension drugs were still needed. No patients had recurrent tumor during the follow-up. Conclusions Retroperitoneal laparoscopic can be the first choice for adrenal tumors, as it is safe and effective with minimal invasion, quick recovery, and short postoperative hospital stay.