摘要
目的探讨后腹腔镜切除肾上腺病变的手术方法和效果。方法对23例肾上腺病变患者行后腹腔镜肾上腺切除术。经腰部置入3个Trocar,手指法建立后腹膜气腹,建立腹膜后操作通道。游离出病变肾上腺达中央静脉后以钛夹夹闭后切断,将切除的肾上腺置入标本袋后取出。结果本组除2例改为开放手术外均获得成功,手术时间55～300min,平均70min。术中出血10～100ml,平均30ml,所有病例均未输血。2例中转开放手术,均为腹膜破裂致后腹腔显露困难所致。无大出血、感染、腹腔脏器损伤等并发症发生。随访1～24个月,平均8个月,未发现肿瘤复发和转移。结论后腹腔镜肾上腺切除术是治疗肾上腺疾病的一种微创、安全、有效的手术方式。
Objective To explore the the operative methods and clinical value of retroperitoneal laparoscopic adrenalectomy for adrenal diseases. Methods 23 patients with adrenal diseases underwent retroperitoneal laparoscopy adrenalectomy. 3 trocars were introduced into the lumbar part. The retroperitoneal working space developed with finger dissection, and the lesion of adrenal gland was dissociated until close to central vein, which was clamped with titanium clips and then resected. Lastly take out the resected adrenal gland which enclosed in a specimen bag. Results All the operations were performed successfully, except that 2 cases were converted to open surgery due to the rupture of peritoneal,which result in difficult exposure of retroperitoneal cavity. Operative times ranged from 55 to 300 minutes, with an average of 70 minutes. Blood loss volumes ranged from 10 to 100ml during operation, with an average of 30 ml. No blood transfusion and no complications such as massive hemorrhage,infection,abdominal visceral injury etc. The follow-up time ranged from 1 to 24 months, with an average of 8 months. No tumor recurrence and metastasis were found in 23 cases. Conclusion Retroperitoneal laparoscopic adrenalectomy should be the first choice for adrenal operation due to its good advantages, such as minimal invasion, safety, effectivity, and rapid postoperative recovery.
出处
《中华腔镜泌尿外科杂志（电子版）》
2010年第2期30-32,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
后腹腔镜
肾上腺肿瘤
切除术
Adrenal tumors
Retroperitoneal
Laparoscopic therapy
