后腹腔镜治疗肾上腺嗜铬细胞瘤

目的 评价后腹腔镜肾上腺切除治疗嗜铬细胞瘤的临床价值.方法 对本院2000年2月～2008年12月25例后腹腔镜治疗肾上腺嗜铬细胞瘤的临床资料进行回顾性分析.左侧15例,右侧10例,肿瘤直径3.0 - 5.6 cm,平均4.2 cm.结果 除3例因出血和肿瘤粘连严重中转开放手术外,其余22例均成功切除肿瘤.手术时间67～210min,平均123min;手术出血量50～450mL,平均120mL;术中下腔静脉破裂2例,均在腹腔镜下完成修补;1例术后24小时死于继发出血.术后病理诊断24 例为良性肾上腺嗜铬细胞瘤,1例为低度恶性肾上腺嗜铬细胞瘤.术后住院时间8～20天,平均12天.随访5～36个月,平均12个月,除1 例需口服降压药外,其余血压恢复正常,24 小时尿VMA 检查正常,无远期并发症,未见肿瘤复发.结论 后腹腔镜肾上腺肿瘤切除术对最大径<6cm肾上腺嗜铬细胞瘤安全、有效、创伤少、出血少、恢复快.术前准备和术后处理在治疗嗜铬细胞瘤的过程中具有重要价值.

Retroperitoneoscopic Adrenalectomy for Pheochromocytoma

Objectives To evaluate the efficaey of rotroperitoneoseopic adrenaleetomy for pheochmmoeyto - ma.Methods From February 2000 to December2008,a total of 25 patients with pheoehromoeytoma received ret - ropefitoneoseopic ad~nalectomy in our hospital.Among the cases,15 had the tumor on the left side.and 10 on theright.The size of the tumors ranged from 3.0 to 5.6 cm in diameter(mean,4.2cm).Results The retroito - neoscopic adrenalectomy was completed in 22 cases,three of the patients,who were converted to open surgery be - cause of extensive adhesion of the tumor to surrounding tissues and massive bleeding.The operative time was 67~210min with a mean of l23min;The blood loss was 50~450mL with amean of l20mL;The rupture of the inferior ve - na cava occurred in two cases,and was repaid under alaperoscope.One pheochromocytonm was died from seconda - ry hemorrhage in 24hours of operation.Postoperative examination showed benign pheochromocytonm in 24 of the ca - ses,and the other one showed low - grade malignant pheochromocytoma.The mean postoperative hospital stay was 12days (8~20).The patients were followed up for 5 to 36months (mean,12),during which only one received anti - hypertensive drugs;the other restored normal blood pressure spontaneously;none of them hadlong - tonn complication or recurrent.Conclusions Retroperitoneal Laparoscopic Adrenalectomy (RLA) is a safe and effective procedure with less invasion and blood loss,a short convalescence in the pheoehromoeytoma whose maximum diameters are less than 6cm.Preoperative preparation and postoperative treatment are important forthe outomes of the disease.