摘要
目的探讨腹腔镜手术治疗巨大肾上腺肿瘤的可行性和手术技巧,寻找微创治疗巨大肾上腺肿瘤的新路径。方法该组13例,包括嗜铬细胞瘤4例5侧,恶性淋巴瘤2例,节细胞神经瘤2例,髓质脂肪瘤3例,无功能腺瘤1例,肾上腺增生伴巨大腺瘤形成1例2侧。肿瘤最大径7～18cm,均采用经腹腔路径腹腔镜手术治疗。结果13例手术均获得成功,其中3例术中采用手辅助方法获得成功。手术时间40～260min,平均148min。术中出血量50～1000mL,平均470mL,3例嗜铬细胞瘤术中出血为1000、900和800mL,予输血,输血量为1600、1200和800mL。患者术后镇痛药盐酸吗啡用量10～40mg,平均20mg。术后住院时间5～14d,平均9d。结论在技术娴熟的条件下,腹腔镜治疗巨大肾上腺肿瘤是安全、可行的。手术创伤小,患者痛苦少,恢复快,是治疗巨大肾上腺肿瘤的可选择的微创技术。
[Objective] To summarize the initial experience of transperitoneal laparoscopic adrenalectomy for enormous adrenal tumor. [Methods] Transperitoneal Laparoscopic adrenalectomy was performed on 13 patients with enormous adrenal tumor, including 4 cases of pheochromocytoma, 2 ganglioneuroma, 3 myelolipoma and 2 malignent lymphoma, 1 non-function tumor, and 1 hyperplasia with giant tumor. Tile largest dimension of tumors were from 7 to 18 cm. [Results] The operations were successful in all 13 cases. The procedure was converted to hand-assisted laparoscopic adrenalectomy in 3 cases, because the tumors being close to inferior vena cava. Tile mean operation time was 148 minutes （range 40 to 260 min）. Tile intraoperative bleeding volume was 470 mL （range 50 to 1000 mL）, the pheochromocytoma was 1000, 900 and 800 mL and the amount of blood transfused was 1600, 1200 and 800 mL respectively. The mean analgesia consumed 20 mg （10-40 mg） of morphine. Tile mean postoperative hospital stay was 9 d （range 5 to 14 d）. [Conclusions] Based upon the experience and skills of the surgeons, transperitoneal laparoscopic adrenalectomy for enormous adrenal tumor is feasible and safe.
出处
《中国内镜杂志》
CSCD
北大核心
2008年第5期537-538,541,共3页
China Journal of Endoscopy
