摘要
目的探讨后腹腔镜单层面下以膈下静脉为标志的肾上腺切除术在治疗左侧肾上腺疾病中的临床可行性及意义。方法回顾性分析2015年7月至2016年12月48例行后腹腔镜左肾上腺切除患者的临床资料,男21例,女27例,平均年龄43岁。手术采用经肾外上方肾周脂肪囊与腰大肌筋膜间相对无血管的腰肌前平面入路,以左膈下静脉为解剖标志寻找并处理中央静脉进行左侧肾上腺切除。结果本组48例手术均顺利完成。平均手术时间28 min,平均术中出血量20 ml,肠道功能恢复时间与下床活动时间分别为20 h和16 h,平均术后住院天数5 d。除2例腺瘤与1例皮质增生患者术后6个月血压控制欠佳外,其余患者临床症状均消失或明显改善。结论后腹腔镜单层面左侧肾上腺切除术中,选择膈下静脉作为解剖标志,可快速定位控制中央静脉,减少术中出血及血压波动。
Objective To investigate the clinical feasibility and value of the application of the inferior phrenic vein as the marker in retroperitoneal laparoscopic single-site adrenalectomy for the treatment of left adrenal disease. Methods The clinical data of 48 patients （male： n=21, female： n=27, average age=43 years） who underwent retroperitoneal laparoscopic left adrenalectomy from July 2015 to December 2016 were retrospectively analyzed. The operation was performed through the relative non vascular approach between the superior and the posterior of renal adipose capsule and the posterior layer of the Gerota fascia. The left inferior phrenic vein was used as the anatomical landmark to search for and ligate the central vein. Results Forty eight operations were performed successfully. The average operation time was 28 min. The mean blood loss was 20 ml. The recovery time of bowel function and ambulation time were 20 hours and 16 hours respectively. The average postoperative hospital stay was 5 days. Forty five of 48 patients had symptomatic diapperance or improvement except for 2 cases with adenoma and 1 patient with cortical hyperplasia. Conclusions Using inferior phrenic vein as a marker in retroperitoneal laparoscopic left single-site adrenaleetomy that could locate and control the central vein quickly, redue blood loss and blood pressure fluctuations.
作者
王琦
于德新
王毅
邹慈
马嘉兴
Wang Qi;Yu Dexin;Wang Yi;Zou Ci;Ma Jiaxing.(Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2018年第2期90-93,共4页
Chinese Journal of Endourology(Electronic Edition)
关键词
膈下静脉
单层面
肾上腺切除术
解剖
Inferior phrenic vein
Single-site
Adrenalectomy
Anatomy
