23例腹腔镜下单侧6cm以上肾上腺嗜铬细胞瘤切除的诊疗体会

目的 腹腔镜下单侧6 cm以上肾上腺嗜铬细胞瘤切除的临床诊疗体会.方法 总结2012年5月至2016年3月本科室采用不同腹腔镜入路处理的23例单侧6 cm以上嗜铬细胞瘤的临床资料及术中情况.结果 23例均在腹腔镜下成功完成手术.肿瘤直径6.5 ～9.8cm,平均7.9 cm,术中出血量30 ～ 700 mL,平均258.3 mL,3例给予术中输血扩容.术后住院时间5～12 d,整体平均7.6d.术后随访1～46个月.12例高血压患者中3例血压恢复正常,另外9例仍需口服降压药,2例糖尿病患者术后均需术前原方案继续降糖治疗,暂未发现复发及转移病例.结论 腹腔镜下单侧6 cm嗜铬细胞瘤切除安全可行,值得临床推广应用,术后仍需定时随访生化指标和影像学资料.

Reflections on the management of unilateral laparoscopic resection of adrenal pheochromocytoma sized over 6 cm

Objectives To investigate on the management of laparoscopic unilateral resection of adrenal pheochromocytoma sized over 6 cm.Methods The clinical data and perioperative conditions of 23 patients receiving treatment for unilateral pheochromocytoma sized over 6 cm through different laparoscopic approaches in our department from May 2012 to March 2016 were summarized.Results All the 23 patients completed the laparoscopic surgery successfully.The tumor diameter was 6.5 ～ 9.8 cm,with the mean 7.9 cm.The perioperative blood loss was 30 ～ 700 mL,with the mean 258.3 mL,and 3 patients received blood transfusion and volume expansion.Patients were followed up1 ～ 46 months after operation,12 patients with hypertension,3 patients had the blood pressured normalized,and 9 patients remained on oral hypotensive drugs,and the 2 patients with diabetes mellitus continued requiring the original preoperative hypoglycemic treatment.None of the patients was observed with relapse or metastasis.Conclusions Unilateral laparoscopic resection of pheochromocytoma sized over 6 cm is safe and feasible,and worthy of being widely applied in clinic.Regular follow-up of the biochemical and imaging indicators is still required after surgery.