单孔后腹腔镜解剖性肾上腺切除术5例报告

目的：初步探讨单孔后腹腔镜肾上腺切除术的临床可行性和安全性。方法：2009年7～8月采用单孔后腹腔镜肾上腺切除术治疗肾上腺肿瘤患者5例，其中男性患者2例，女性患者3例，平均年龄（58．4±3．6）岁，平均体重指数（25．9±2．6）；左侧3例，右侧2例；肾上腺皮质无功能腺瘤3例，肾上腺醛固酮瘤2例。行肾上腺全切术1例，肾上腺肿瘤切除术4例。3例患者术后留置引流管，2例患者未留置引流管结果：5例单孔后腹腔镜肾上腺切除术均顺利完成，手术时间35～60min，平均（51．2±11．2）min；肿瘤最大径1．0～3．5cm，估计出血量5～10ml，平均（8．0±2．7）ml，无中转开放及转为标准三孔腹腔镜手术，术中发生1例腹膜破裂，给予修补，无其他并发症发生，短期随访无术后并发症发生。结论：初步结果显示了单孔后腹腔镜肾上腺切除术具有良好的安全性和可行性，但其临床治疗效果尚需大样本中远期随访和对照研究予以证实。

Single-Port Anatomical Retroperitoneoscopic Adrenalectomy (Report of 5 Cases)

Objective：To present the initial operative outcomes and feasibility of single-port anatomical retroperitoneoscopic adrenalectomy （SP-ARA）. Methods： From July 2009 to August 2009, 5 patients （2 men and 3 women） underwent SP-ARA by one surgical team. The mean patient age was（58.4±3.6）years. The mean body mass index was（25.9±2.6）kg/m^2. 3 tumors on the left side and 2 on the right side. Non-functional adrenal cortical adenoma in 3 cases, adrenal aldosterone-producing adenoma in 2 cases. Total adrenalectomy in 1 cases, and 4 case of partial adrenalectomy. 3 cases with postoperative indwelling drainage tube, and 2 cases without indwelling drainage tube. Results：5 cases of SP-ARA were performed successfully. The operating time was 35-60 min, average （51.2±11.2）min, the longest tumor diameter was 1.0-3.5 cm, and the estimated blood loss is 5-10 ml, average（8.0±2.7）ml. No conversion to open or 3-port laparoscopic surgery was necessary. Peritoneum rupture was repaired in one case. No intra-operative complications was observed, no post-operative complications after a short- term follow-up. Conclusions：Initial study on SP-ARA has shown its clinical safety and feasibility. However, those results should be proved by further large-scale control study and long-term follow-up.