中国癌症杂志
中國癌癥雜誌
중국암증잡지
China Oncology
2015年
10期
828-831
,共4页
万方宁%张海梁%叶定伟%张桂铭%顾成元%戴波%张世林%沈益君%朱耀%施国海%朱一平
萬方寧%張海樑%葉定偉%張桂銘%顧成元%戴波%張世林%瀋益君%硃耀%施國海%硃一平
만방저%장해량%협정위%장계명%고성원%대파%장세림%침익군%주요%시국해%주일평
腹腔镜%肾上腺占位切除术%腹膜后入路
腹腔鏡%腎上腺佔位切除術%腹膜後入路
복강경%신상선점위절제술%복막후입로
Retroperitoneal adrenalectomy%Peri-operative complication%Adrenal neoplasms
背景与目的：较开放手术，腹腔镜肾上腺占位性病变切除术具有微创与视野清晰的优点。该研究拟探讨后腹腔镜肾上腺占位性病变切除的临床价值。方法：回顾性收集2007年1月—2012年12月在复旦大学附属肿瘤医院行后腹腔镜肾上腺占位性病变切除术的患者共130例，比较患者临床病理特征、并发症情况及短期预后。结果：在130例患者中，男性63例，女性67例，平均年龄50岁。病理类型：肾上腺皮质腺瘤68例，嗜铬细胞瘤15例，髓样脂肪瘤13例，囊肿10例，节细胞神经瘤7例，转移性癌5例，肾上腺皮质增生4例，神经鞘瘤3例，淋巴管瘤2例，肾上腺血肿1例，肾上腺皮质癌1例，肾上腺血管肉瘤1例，副脾脏1例(其中1例患者同时患有嗜铬细胞瘤和节细胞神经瘤)。肿瘤最大直径为0.5~9.0 cm，平均为3.48 cm，平均术中出血量为62.73 mL，平均术后住院时间为7 d。其中3例患者转为开放手术，另有5例患者发生术后并发症，其中发热2例，食物过敏1例，药物过敏1例，低血钾1例。结论：后腹腔镜肾上腺占位性病变切除术具有创伤小、安全性高，患者术后恢复快的优点，有利于在有条件的中心开展。
揹景與目的：較開放手術，腹腔鏡腎上腺佔位性病變切除術具有微創與視野清晰的優點。該研究擬探討後腹腔鏡腎上腺佔位性病變切除的臨床價值。方法：迴顧性收集2007年1月—2012年12月在複旦大學附屬腫瘤醫院行後腹腔鏡腎上腺佔位性病變切除術的患者共130例，比較患者臨床病理特徵、併髮癥情況及短期預後。結果：在130例患者中，男性63例，女性67例，平均年齡50歲。病理類型：腎上腺皮質腺瘤68例，嗜鉻細胞瘤15例，髓樣脂肪瘤13例，囊腫10例，節細胞神經瘤7例，轉移性癌5例，腎上腺皮質增生4例，神經鞘瘤3例，淋巴管瘤2例，腎上腺血腫1例，腎上腺皮質癌1例，腎上腺血管肉瘤1例，副脾髒1例(其中1例患者同時患有嗜鉻細胞瘤和節細胞神經瘤)。腫瘤最大直徑為0.5~9.0 cm，平均為3.48 cm，平均術中齣血量為62.73 mL，平均術後住院時間為7 d。其中3例患者轉為開放手術，另有5例患者髮生術後併髮癥，其中髮熱2例，食物過敏1例，藥物過敏1例，低血鉀1例。結論：後腹腔鏡腎上腺佔位性病變切除術具有創傷小、安全性高，患者術後恢複快的優點，有利于在有條件的中心開展。
배경여목적：교개방수술，복강경신상선점위성병변절제술구유미창여시야청석적우점。해연구의탐토후복강경신상선점위성병변절제적림상개치。방법：회고성수집2007년1월—2012년12월재복단대학부속종류의원행후복강경신상선점위성병변절제술적환자공130례，비교환자림상병리특정、병발증정황급단기예후。결과：재130례환자중，남성63례，녀성67례，평균년령50세。병리류형：신상선피질선류68례，기락세포류15례，수양지방류13례，낭종10례，절세포신경류7례，전이성암5례，신상선피질증생4례，신경초류3례，림파관류2례，신상선혈종1례，신상선피질암1례，신상선혈관육류1례，부비장1례(기중1례환자동시환유기락세포류화절세포신경류)。종류최대직경위0.5~9.0 cm，평균위3.48 cm，평균술중출혈량위62.73 mL，평균술후주원시간위7 d。기중3례환자전위개방수술，령유5례환자발생술후병발증，기중발열2례，식물과민1례，약물과민1례，저혈갑1례。결론：후복강경신상선점위성병변절제술구유창상소、안전성고，환자술후회복쾌적우점，유리우재유조건적중심개전。
Background and purpose:Laparoscopic retroperitoneal adrenalectomy makes access to the adrenal glands easier and less invasive than open surgery. The aim of this study was to evaluate the clinical efifcacy of laparoscopic retroperitoneal adrenalectomy.Methods:A total of 130 patients who underwent retroperitoneal adrenalectomy for adrenal mass from Jan. 2007 to Dec. 2012 in Fudan University Shanghai Cancer Center were retrospectively assessed. Their clinicopathological factors, perioperative complications and short-term prognostic data were retrieved from the medical records.Results:One hundred and twenty-seven of 130 patients underwent retroperitoneal adrenalectomy successfully, and 3 patients were converted to open surgery due to severe bleeding. Among 130 patients, 63 were male and 67 were female, with the mean age 50.0 years. The pathological results of the 130 patients indicated adrenocortical adenoma in 68, pheochromocytoma in 15, medullary lipoma in 13, adrenal cysts in 10 , ganglioneuroma in 7, metastatic cancer in 5, adrenal hyperplasia in 4, schwannoma in 3, lymphangioma in 2, adrenal hematoma in 1, adrenal cortical carcinoma in 1, adrenal angiosarcoma in 1 and the deputy spleen in 1 (one patient suffering from both pheochromocytoma and ganglioneuroma). The maximum diameters were ranging from 0.5 to 9.0 cm, and mean diameter was 3.48 cm. The average blood loss in surgery was 62.73 mL. Mean length of stay in hospital was 7 d. GradeⅠ complications occurred in 5 patients, including 2 of fever, 1 of food allergy, 1 of drug allergy and 1 of hypokalemia.Conclusion: Retroperitoneal adrenalectomy should be considered as the procedure of choice for the resection of most adrenal tumors in skilled centers with the advantages of minimal invasion, increased safety and faster recovery.
