腹腔镜肾上腺嗜铬细胞瘤切除术七例报告

目的探讨腹腔镜手术治疗肾上腺嗜铬细胞瘤的可行性及安全性。方法2003年10月至2007年4月，我院行腹腔镜肾上腺嗜铬细胞瘤切除术7例，肿瘤最大径为3．0～6．5cm，平均5．0cm。6例患者术前均有不同程度的高血压。术前常规行降压、扩容处理。采用后腹腔镜入路6例，经腹入路1例，术中术后严密监测血压变化并给予相应处理。结果5例腹腔镜手术成功，2例中转开放手术。手术时间为70-360min，平均163min，术中出血50-600ml，平均300ml。7例患者术中均出现血压波动，无围手术期患者死亡。病理报告证实为嗜铬细胞瘤。随访7～49个月，5例患者术后2个月内血压恢复正常，1例仍需服用降压药物。结论腹腔镜肾上腺嗜铬细胞瘤切除术可行，疗效确切，充分的术前准备和熟练的腹腔镜操作技术是手术安全的保证。

Laparoscopic adrenalectomy for pheochromocytoma (report of 7 cases)

Objective To investigate the clinical feasibility and safety of laparoscopic adrenalectomy for the treatment of pheochromocytoma. Methods From October 2003 to April 2007, 7 laparoscopic adrenalectomies for pheochromocytoma were performed. The mean tumor size was 5.0 cm in diameter （range 3.0 to 6.5 cm）. Six patients had hypertension before the operation and 1 case didn＇t. The preoperative preparations included modulating blood pressure and expanding blood volume. 6 retroperitoneoscopic adrenalectomies and 1 laparoscopic adrenalectomy were performed. Blood pressure fluctuation was monitored intensively during and after operation, Results Laparoscopic adrenalectomies were completed successfully in 5 Patients and 2 cases were converted to open surgery. Mean operating time was 163 rain （range 70 to 360 rain）. Mean estimated blood loss was 300 ml （range 50 to 600 ml）. Conspicuous fluctuation of blood pressure was observed in all cases during operation. There were no major intraoperative complications occurred. Seven cases were pathologically diagnosed as pheochromocytoma. All cases were followed up for 7 to 49 months. Postoperative blood pressure was normal in 5 cases within 2 months without any drug administration. Dosage of antihypertensive drugs was decreased in the remainder. Conclusions As long as preoperative preparations are adequate and intraoperative manipulations are careful, laparoscopic adrenalectomy for the treatment of pheochromocytoma could be a safe, feasible and minimally invasive procedure.