微创手术及开放手术治疗肾上腺肿瘤的疗效比较(附232例报告)

目的:分析并比较腹腔镜手术及开放手术治疗肾上腺肿瘤的效果。方法:回顾性分析2003～2009年住院手术治疗的232例肾上腺肿瘤患者的临床资料,分别对行开放手术及腹腔镜手术患者进行比较,分析手术时间、术后住院时间、术后引流管留置情况、手术输血情况4项指标,评价开放手术及微创手术在肾上腺肿瘤治疗中的效果。结果:232例患者中,行开放手术治疗者41例(开放组),腹腔镜手术治疗者185例(腹腔镜组),腹腔镜手术中转开放手术者6例。肾上腺肿瘤大小平均为(2.57±1.31)cm×(4.08±2.45)cm×(5.30±3.38)cm。开放组手术时间、术后住院时间、术后引流管留置情况及手术输血再分别为(121.94±48.83)min、(8.94±3.09)天、(3.74±2.77)天和16例;腹腔镜组为(85.47±36.84)min、(6.69±3.93)天、(2.53±0.73)天和13例(均P0.005)。结论:在肾上腺肿瘤治疗方面,腹腔镜手术与传统开放手术相比具有手术时间短、患者术后恢复快、术后引流管留置时间短及输血率较低等优点。

The Effect Comparison Between Minimally Invasive Surgery and Open Surgery for Adrenal Tumors(Reports of 232 Cases)

Objective：To summarize and analyze the expertise and strategy that is the open and laparoscopic surgery for adrenal neoplasm. Methods：A Total of 232 patients （from 2003 to 2009） with adrenal neoplasm were enrolled in the retrospective study, evaluated the effectiveness of open and laparoscopic treatment for adrenal neoplasm, compared the operative time, hospitalization after surgery, drainage duration, transfusion, etc between the traditional open and laparoscopic surgery groups, respectively. Results：Among the eligible 232 patients , the tradi tional open surgery, laparoscopic surgery and transformation, from laparoscopic to open, was 41, 185, 6, respectively. The amount of neoplasm was approximate （2.57±1.31）cm）〈 （4.08±2.45）cm）〈 （5.30±3.38）cm. The surgery duration, hospitalization after surgery, drainage duration and transfusion of traditional open group was （121.94±48.83）minute,（8.94±3.09）days,（3.74±2.77）days, 16 cases, respectively, and these of laparoscopic group was（85. 47 ± 36. 84 ） minute, （ 6. 69± 3. 93 ） days, （ 2. 53± 0. 73 ） days, 13 cases, respectively（entire P〈 0. 005）. Conclusions：Comparing with open surgery, laparoscopic surgery for adrenal neoplasm has shorter opera tive time, better recovery after treatment, shorter drainage duration, lower prevalence of transfusion, etc.