腹腔镜下巨大肾上腺肿瘤切除术7例报告

目的：探讨腹腔镜下肾上腺巨大肿瘤（直径≥6 cm）切除术的技术方法和应用价值.方法：7例肾上腺肿瘤患者均行腹腔镜下肾上腺肿瘤切除术,在瘤体表面相对无血管区处切开包膜,沿包膜与瘤体之间迅速分离,切除肿瘤,填塞纱布止血.结果：5例腹腔镜下肾上腺肿瘤切除术顺利完成,1例手助腹腔镜下完成,1例粘连明显转开放手术.平均手术时间120 min;平均术中出血量200 ml.术后1～4天肠功能恢复,3～5天拔除引流管;无明显外科并发症,术后住院平均10天.术后病理诊断嗜铬细胞瘤4例,肾上腺囊肿1例,神经节细胞瘤1例,畸胎瘤1例.术后随访6（3～18）个月,临床症状消失,复查彩超及SCT未见肿瘤复发及恶性变.结论：腹腔镜下肾上腺肿瘤切除术创伤小、恢复快、效果满意,是治疗巨大肾上腺肿瘤的一种理想术式.

Laparoscopic Enucleation for the Treatment of Huge Adrenal Tumors(Report of 7 cases)

Objective：To evaluate the safety and feasibility of laparoscopic enucleation for the treatment of huge adrenal tumors（diameter≥6 cm）. Methods： Seven cases of huge adrenal tumors underwent laparoscopic resection of adrenal tumors, the tumor is relatively avascular zone at the surface of envelope incision along the rapid separation between the capsule and the tumor, resection of tumor, gauze packing to stop bleeding. Results：5 cases were successful, 1 case was completed by hand-assisted laparoscopic resection and 1 case was completed by open surgery because of intraoperative bleeding and extensive adhesion. The average operation time was 120 min, the average blood loss was 200 ml. After surgery intestinal function was recovery in 1-4 days,removal of drainage tube in 3-5 days;No complication occurred, the average hospital stay after operation was 10 days. The pathological reports showed 4 cases of ehromaffinoma, 1 case of adrenal cyst, 1 case of adrenal teratoma and 1 cases of paraganglioma. After surgery followed up for 3-18 months（mean 6 months）. These cases had rapid postoperative recovery and the clinical symtoms disappeared. Conclusions： Laparoscopic enucleation of adrenal tumors could be considered as a good choice in treating huge adrenal tumors because of its less invasive and more effective.