摘要
目的:探讨经腹腹腔镜治疗大体积(>6cm)嗜铬细胞瘤的安全性和效果。方法:回顾性分析21例接受腹腔镜手术治疗的大体积嗜铬细胞瘤患者的临床资料,患者年龄27～66岁,平均(47.8±11.5)岁。左侧14例,右侧7例,最大径6.3～14.5cm,平均(8.5±2.3)cm,所有病例术前给予20～60mg/d酚苄明准备2～4周。结果:所有病例均采用经腹腹腔镜肾上腺肿瘤切除术,2例因与肝脏、下腔静脉粘连而改为开放手术,手术时间分别为260和300min,出血量分别为800和1 000ml;余病例手术时间115～230min,平均(160.7±33.2)min。术中出血量70～360ml,平均(124.1±71.5)ml。21例术后住院7～10d,平均(8.2±0.9)d,无严重并发症。随访6～60个月,1例出现腹盆腔转移,死于术后13个月。结论:在良好的术前准备和细心的术中操作前提下,经腹腹腔镜肾上腺肿瘤切除术是治疗大体积嗜铬细胞瘤的安全选择。
Objective:To evaluate the efficancy and safety of transperitoneal laparoscopic adrenalectomy for large pheochromocytoma(with diameter greater than 6 cm).Methods:A restrospective analysis was performed on21 patients who underwent laparoscopic adrenalectomy for large pheochromocytoma.All patients were prepared by20-60 mg dose of phenoxybenzamine per day for 2 to 4 weeks before the surgery.Results:The mean age was(47.8±11.5)years(range 27-66).There were 14 cases of lesions located in left side and 7 cases in opposite.The mean diameter was(8.5±2.3)cm(range:6.3-14.5 cm).All cases were treated with transperitoneal laparoscopic adrenalectomy and two of them were converted to open operation due to adhesion to liver and inferior vena cava.The mean surgical time was(160.7±33.2)min(range:115 to 230 min).The volume of hemorrhage was(124.1±71.5)mL(range:70 to 360 mL).For two open cases,surgical time were 260 and 300 min,and the volumn of hemorrhage were 800 and 1 000 mL respectively.The mean hospital stay after operation was(8.2±0.9)days(range:7 to 10 days),and no major intraoperative complications occured.All cases were follewed up for 6 to 60 months,and one patient was recurred with abdomen metastasis and died in 13 months after operation.Conclusions:With adequately preoperative preparation and carefully intraoperative manipulation,transperitoneal laparoscopic adrenalectomy could be a safe and minimally invasive procedure for large pheochromocytoma.
出处
《微创泌尿外科杂志》
2018年第5期297-301,共5页
Journal of Minimally Invasive Urology
