66例后腹腔镜肾上腺肿瘤切除术

目的总结后腹腔镜肾上腺手术的临床经验，提高治疗水平。方法回顾性分析我院泌尿外科应用后腹腔镜技术施行的66例肾上腺肿瘤切除术的临床资料。肿瘤位于左侧22例，右侧44例；直径1．2～6．4cm，平均3．3cm。元功能肾上腺腺瘤36例，原发性醛固酮增多症13例，肾上腺嗜铬细胞瘤10例，肾上腺髓性脂肪瘤6例，肾上腺囊肿1例。结果62例手术获得成功，4转开放手术。手术时间35～190min，平均90min。术中出血20～800ml，平均70ml，术中或术后输血5例。术后随访3～36个月，平均16个月，均无远期并发症及肿瘤复发。结论后腹腔镜肾上腺肿瘤手术安全，创伤小，恢复快，住院时间较短，是肾上腺良性肿瘤的首选术式。

Retroperitoneal laparoscopic adrenalectomy in 66 cases

Objective To summarize the operative experience and to study the value and efficacy of retroperitoneal laparoseopie adrenaleetomy.Methods Clinical data of 66 cases undergoing retroperitoneal laparoscopic adrenalectomy in Yijishan Hospital were retrospectively reviewed.There were 22 cases with adrenal adenoms located at left side and 44 cases at fight side.Tumor diameter was from 1.2 to 6.4 cm,with 3.3 cm as the average.There were 36 cases of nonfunctional adrenal adenoma,13 cases of primary hyperaldosteronism,10 cases of adrenal pheochromocytoma,6 cases of adrenal myelolipoma,and 1 case of adrenal cyst.Results 4 cases were converted to open surgery while the other 62 cases were completed successfully.The operation duration was from 35 to 190 min,with 90 min as the average.Intraoperative blood loss was from 20 to 800 ml,with 70 ml as the average.5 cases received blood transfusion because of massive hemorrhage.All cases were followed up for 3to 36 months.None of them had long-term complications or recurrence.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of safety,less trauma,short hospitalization time,and quick recovery,making it the flint choice for patients with benign adrenal neoplasms.