医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2013年
9期
96-97
,共2页
柳学春%张颖鄂%熊国光%钱开宇%李颢%叶达夫%何鹏%韦伟
柳學春%張穎鄂%熊國光%錢開宇%李顥%葉達伕%何鵬%韋偉
류학춘%장영악%웅국광%전개우%리호%협체부%하붕%위위
肾上腺疾病%腹腔镜术%后腹腔
腎上腺疾病%腹腔鏡術%後腹腔
신상선질병%복강경술%후복강
Adrenal disease%Laparoscopy%Retroperitoneum
目的探讨后腹腔镜手术治疗肾上腺疾病的适应症及手术安全性及其疗效。方法总结2009年1月~2011年5月采用后腹腔镜治疗32例肾上腺疾病患者的临床资料。结果31例腹腔镜手术顺利完成，1例在开展腹腔镜技术早期因瘤体破裂出血，腹腔镜下止血困难中转开放手术，其中嗜铬细胞瘤7例，肾上腺皮质增生5例，肾上腺皮质腺瘤11例，髓性脂肪瘤1例，肾上腺囊肿2例，其他无功能肿瘤6例。手术时间平均（75±29）min。术中出血平均（57±42）ml，均未输血。患者术后1~3d排气后恢复进食，1~2d可下床活动。术后住院时间平均（6±0.8）d。随诊所有患者影像学检查未见肿瘤复发或转移；功能性肿瘤患者症状减轻或消失。结论后腹腔镜手术具有创伤小、疼痛轻、康复快等优点，且治疗效果肯定，是肾上腺良性疾病首选手术方法。
目的探討後腹腔鏡手術治療腎上腺疾病的適應癥及手術安全性及其療效。方法總結2009年1月~2011年5月採用後腹腔鏡治療32例腎上腺疾病患者的臨床資料。結果31例腹腔鏡手術順利完成，1例在開展腹腔鏡技術早期因瘤體破裂齣血，腹腔鏡下止血睏難中轉開放手術，其中嗜鉻細胞瘤7例，腎上腺皮質增生5例，腎上腺皮質腺瘤11例，髓性脂肪瘤1例，腎上腺囊腫2例，其他無功能腫瘤6例。手術時間平均（75±29）min。術中齣血平均（57±42）ml，均未輸血。患者術後1~3d排氣後恢複進食，1~2d可下床活動。術後住院時間平均（6±0.8）d。隨診所有患者影像學檢查未見腫瘤複髮或轉移；功能性腫瘤患者癥狀減輕或消失。結論後腹腔鏡手術具有創傷小、疼痛輕、康複快等優點，且治療效果肯定，是腎上腺良性疾病首選手術方法。
목적탐토후복강경수술치료신상선질병적괄응증급수술안전성급기료효。방법총결2009년1월~2011년5월채용후복강경치료32례신상선질병환자적림상자료。결과31례복강경수술순리완성，1례재개전복강경기술조기인류체파렬출혈，복강경하지혈곤난중전개방수술，기중기락세포류7례，신상선피질증생5례，신상선피질선류11례，수성지방류1례，신상선낭종2례，기타무공능종류6례。수술시간평균（75±29）min。술중출혈평균（57±42）ml，균미수혈。환자술후1~3d배기후회복진식，1~2d가하상활동。술후주원시간평균（6±0.8）d。수진소유환자영상학검사미견종류복발혹전이；공능성종류환자증상감경혹소실。결론후복강경수술구유창상소、동통경、강복쾌등우점，차치료효과긍정，시신상선량성질병수선수술방법。
Objective To evaluate the indication, safety and ef icacy of retroperitoneal laparoscopic surgery for adrenal diseases.Methods From January 2009 to May 2011, retroperitoneal laparoscopic surgery was performed on 32 patients in our hospital. The clinic data of the 32 patients was summarized retrospectively.Results Among the 32 cases of retroperitoneal laparoscopic surgery, 31 cases were successful y completed and 1 case was converted to open surgery because of bleeding in the early stage when we started retroperitoneal laparoscopic surgery. The 32 cases included 7 cases of adrenal pheochromocytoma , 5 cases of adrenal cortical hyperplasia, 11 cases of adrenal cortical adenoma, 1 case of adrenal myelolipoma, 2 cases of adrenal cyst and 6 cases of nonfunctional gland tumors. The mean operation time was 75 (75±29)minutes and mean blood loss was 57(57±42)ml with no need of blood transfusion. The mean postoperative hospital stay was 6(6±0.8)days. No tumor recurrence or metastasis was noted in the 32 cases and the clinical symptom of functional gland tumors was relieved or disappeared. Conclusion Retroperitoneal laparoscopic surgery was ef ective and less traumatic to the patients, with less postoperative discomfort and faster recovery, so the procedure should be considered as the first choice of therapy for benign adrenal diseases.
