后腹腔镜与开放手术治疗肾上腺肿瘤的比较

目的 评价与比较后腹腔镜与开放性手术治疗肾上腺肿瘤的临床价值。方法 行后腹腔镜手术治疗肾上腺良性肿瘤33例，同期行开放性手术治疗肾上腺良性肿瘤31例，比较两种方法手术时间、出血量、术后下床活动时间、术后住院时间的差别。结果 两组切除肿瘤的平均重量比较差异无显著性（P〉0．05）。后腹腔镜组术中的出血量、术后恢复时间、术后住院时间优于开放手术组，差异有显著性（P〈0．01）；两组手术时间后腹腔镜组长于开放手术组，差异有显著性（P〈0．01）；两组均未出现严重并发症。结论 与开放性手术相比，后腹腔镜手术治疗肾上腺肿瘤具有创伤小、术中出血量少、术后下床活动时间和术后住院时间短等优点，已成为肾上腺良性肿瘤手术治疗的首选方法。

A comparative study of retroperitoneal laparoscopic and open adrenalectomy

Objective To compare and evaluate the clinical value among retroperitoneal laparoscopic adrenalectomy and open adrenalectomy for the treatment of adrenal tumours. Methods From Jan 2002 to Dec 2004, retroperitoneal laparoscopic adrenalectomy was performed for 33 cases. 31 cases were successful,during the same period 31 patients with adrenal tumours underwent open adrenalectomy.The procedures were evaluated and a comparative study was made between the two groups. Results There was no significant difference of the average tumours weight between the two groups. In the retroperitoneal laparoscopic adrenalectomy group, blood loss during operation, return to normal and hospital stay after operation were better than those in the open adrenalectomy group( P <0.01), while in the open adrenalectomy group, the mean operating time was less than that in the retroperitoneal laparoscopic adrenalectomy group( P <0.01). There were no severe complications in the two groups. Conclusion The retroperitoneal laparoscopic adrenalectomy has the advantages of micro-invasive, less blood loss,short time return to normal and hospital stay after operation.The procedure should be considered as the first choice of therapy for benign adrenal tumours.