中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2011年
1期
43-45,48
,共4页
范治璐%孙伟%于洋%范维伟
範治璐%孫偉%于洋%範維偉
범치로%손위%우양%범유위
肾上腺肿瘤%后腹腔镜手术%肾上腺肿瘤切除术
腎上腺腫瘤%後腹腔鏡手術%腎上腺腫瘤切除術
신상선종류%후복강경수술%신상선종류절제술
Adrenal tumor%Retroperitoneal laparoscopic surgery%Adrenalectomy
目的 比较开放手术与后腹腔镜手术治疗肾上腺肿瘤的疗效.方法 回顾性分析肾上腺肿瘤行开放性切除术30例(开放组)与行后腹腔镜手术119例(腔镜组)的临床资料,比较两组的手术时间、术中出血量、术后镇痛剂的使用、进食和拔除引流管时间、术后住院天数、并发症及术后肿瘤复发情况.开放组肿瘤直径0.5 cm～10.8 cm,平均4.57 cm;左侧18例,右侧12例.腔镜组肿瘤直径0.8 cm～14.5 cm,平均2.78 cm;左侧59例,右侧60例.术后随访时间开放组6～72个月,腔镜组4～20个月.结果 开放组30例全部成功,腔镜组12例改开放手术,因视野不清8例,肾动脉损伤1例,肿瘤太大1例,膈肌损伤1例,胸膜损伤1例.腔镜组手术时间、术中出血量、术后镇痛剂的使用、进食和拔除引流管时间、术后住院天数优于开放组,差异有统计学意义(P＜0.05).结论 肾上腺肿瘤行后腹腔镜切除术具有创伤小、术中出血少、术后恢复快等优点,已成为现代治疗肾上腺良性肿瘤的金标准.
目的 比較開放手術與後腹腔鏡手術治療腎上腺腫瘤的療效.方法 迴顧性分析腎上腺腫瘤行開放性切除術30例(開放組)與行後腹腔鏡手術119例(腔鏡組)的臨床資料,比較兩組的手術時間、術中齣血量、術後鎮痛劑的使用、進食和拔除引流管時間、術後住院天數、併髮癥及術後腫瘤複髮情況.開放組腫瘤直徑0.5 cm～10.8 cm,平均4.57 cm;左側18例,右側12例.腔鏡組腫瘤直徑0.8 cm～14.5 cm,平均2.78 cm;左側59例,右側60例.術後隨訪時間開放組6～72箇月,腔鏡組4～20箇月.結果 開放組30例全部成功,腔鏡組12例改開放手術,因視野不清8例,腎動脈損傷1例,腫瘤太大1例,膈肌損傷1例,胸膜損傷1例.腔鏡組手術時間、術中齣血量、術後鎮痛劑的使用、進食和拔除引流管時間、術後住院天數優于開放組,差異有統計學意義(P＜0.05).結論 腎上腺腫瘤行後腹腔鏡切除術具有創傷小、術中齣血少、術後恢複快等優點,已成為現代治療腎上腺良性腫瘤的金標準.
목적 비교개방수술여후복강경수술치료신상선종류적료효.방법 회고성분석신상선종류행개방성절제술30례(개방조)여행후복강경수술119례(강경조)적림상자료,비교량조적수술시간、술중출혈량、술후진통제적사용、진식화발제인류관시간、술후주원천수、병발증급술후종류복발정황.개방조종류직경0.5 cm～10.8 cm,평균4.57 cm;좌측18례,우측12례.강경조종류직경0.8 cm～14.5 cm,평균2.78 cm;좌측59례,우측60례.술후수방시간개방조6～72개월,강경조4～20개월.결과 개방조30례전부성공,강경조12례개개방수술,인시야불청8례,신동맥손상1례,종류태대1례,격기손상1례,흉막손상1례.강경조수술시간、술중출혈량、술후진통제적사용、진식화발제인류관시간、술후주원천수우우개방조,차이유통계학의의(P＜0.05).결론 신상선종류행후복강경절제술구유창상소、술중출혈소、술후회복쾌등우점,이성위현대치료신상선량성종류적금표준.
Objective To evaluate and compare open and retroperitoneal laparoscopic adrenalectomy.Methods Clinical data of 30 cases undergoing open adrenalectomy and 119 cases undergoing retroperitoneal laparoscopic surgery were retrospectively analyzed. The 2 groups were compared in terms of these aspects: operation duration, intraoperative blood loss, postoperative analgesic use, time to remove drainage tube, time to resume eat, postoperative hospitalization time, complications, and tumor recurrence. In open surgery group, tumor diameter was between 0.5 cm -10.8 cm, 4.57 cm in average. 18 tumors were located on the left side and 12 tumors on the right side. In laparoscopic group, tumor diameter was between 0.8 cm -14.5 cm, 2.78 cm in average. 59tumors were located on the left side and 60 tumors on the right side. Patients in open surgery group were followed up for 6-72 months and retroperitoneal laparoscopic group 4-20 months. Results Open adrenalectomy were successful in all the 30 cases. 12 cases in laparoscopic surgery group converted to open surgery among whom 8 cases were due to poor visibility, 1 case due to renal artery injury, 1 case due to large tumor size, 1 case because of diaphragmatic injury and 1 case because of pleural injury. Laparoscopic surgery was superior to open surgery in terms of operation duration, intraoperative blood loss, postoperative analgesic use, time to start food taking, time to remove drainage tube, and postoperative hospitalization time. The difference had statistical significance (P ＜0.05 ). Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages such as less trauma, less blood loss, and shorter recovery time, which make this procedure the modern "golden standard" for treatment of benign adrenal neoplasm.
