CAJ | 학술논문

目的：探讨腹腔镜手术治疗儿童肾上腺区巨大肿瘤（直径≥5 cm）的可行性和安全性。方法采用腹腔镜手术治疗的肾上腺区巨大肿瘤患儿5例，其中男3例，女2例；年龄3岁3个月~7岁5个月，平均年龄5.50岁；肾上腺肿瘤均位于右侧，肾上腺病灶最大直径均≥5 cm。结果5例患儿顺利完成腹腔镜手术。手术时间120~210分钟，平均144分钟；术中出血量15~30 ml，平均23 ml；术后住院时间4~10天，平均6天；出现并发症1例，为术中隔肌破裂、右侧肺水肿；术后病理检查证实为神经母细胞瘤1例，节细胞性神经母细胞瘤1例，节细胞神经瘤3例；5例均获随访6~36个月，均未发现肿瘤复发或转移。结论经腹腔镜手术治疗儿童肾上腺区巨大肿瘤切实可行、安全有效，但术前需要依据检查结果选择适当的病例，并由腹腔镜经验丰富、技术娴熟的术者进行。
목적：탐토복강경수술치료인동신상선구거대종류（직경≥5 cm）적가행성화안전성。방법채용복강경수술치료적신상선구거대종류환인5례，기중남3례，녀2례；년령3세3개월~7세5개월，평균년령5.50세；신상선종류균위우우측，신상선병조최대직경균≥5 cm。결과5례환인순리완성복강경수술。수술시간120~210분종，평균144분종；술중출혈량15~30 ml，평균23 ml；술후주원시간4~10천，평균6천；출현병발증1례，위술중격기파렬、우측폐수종；술후병리검사증실위신경모세포류1례，절세포성신경모세포류1례，절세포신경류3례；5례균획수방6~36개월，균미발현종류복발혹전이。결론경복강경수술치료인동신상선구거대종류절실가행、안전유효，단술전수요의거검사결과선택괄당적병례，병유복강경경험봉부、기술한숙적술자진행。
Objective To investigate the feasibility and safety of laparoscopic surgery for pediat-ric adrenal tumor larger than 5 cm. Methods The clinical data of five pediatric cases of laparoscopic sur-gery for large adrenal tumor were reviewed,including two girls and three boys,with an average age of 5. 50 (3. 25 ~ 7. 42)years. All tumors were located at the right side. The maximum diameter of adrenal lesion was larger than 5 cm. Results All the laparoscopic surgeries were successfully performed. The average operative time was 144(120 ~ 210)min,average blood loss 23. 00(15 ~ 30)ml,and average postoperative hospital stay 6(4 ~ 10)d. One case had intraoperative diaphragmatic rupture and right-side pulmonary e-dema. Pathological report revealed one neuroblastoma,three ganglioneuromas and one ganglioneuroblasto-ma. There were no recurrence or metastasis during the follow-up period(6 ~ 36 months). Conclusion For children with large adrenal tumor,laparoscopic surgery is safe,effective,and practicable. According to preoperative examination,appropriate cases should be chosen by skilled surgeons with sufficient experi-ence.