后腹腔镜肾上腺肿物切除术并发症防治的研究

目的:探讨后腹腔镜肾上腺肿物切除术及并发症的防治。方法:回顾分析经后腹腔镜治疗的25例肾上腺患者的临床资料。所有患者术前经临床表现、实验室检查、CT或MRI及术后病理确诊。其中皮质腺瘤18例,无功能腺瘤4例,皮质醇增多症2例,嗜铬细胞瘤1例。肿瘤直径<6 cm。结果:23例手术成功,手术时间60～150 min,平均(95.0±26.8)min,术中平均出血量(130.7±51.4)mL。术中3例出现腹膜损伤,2例出现皮下气肿,2例术中出血中转开放,1例术后出现肾上腺危象。患者术前症状于术后3个月内缓解。结论:完善的围术期处理及熟练的腹腔镜技术是手术成功及减少并发症的关键。

Postoperative complications of laparoscopic resection of adrenal tumor with 25 cases

Objective:To evaluate and prevent the post-operative complications of laparoscopic resection of adrenal tumor.Methods:There were 25 cases with adrenal tumor which underwent laparoscopic resections were retrospected and their clinical data were collected.All patients were diagnosed by preoperative clinical,laboratory,CT,MRI and pathologic diagnosis.This group was consisted by 18 cases of cortical adenoma,4 cases of non-functioning adenomas,2 cases of cushing′s syndrome and 1 case of pheochromocytoma.Results:In current study,the operation of 23 cases was successful,the operation time ranged from 60 to 150 mins,the average time was(95.0±26.8) min,blood loss was(130.7±51.4) mL.There was 3 cases suffered from peritoneal injury,2 cases suffered from subcutaneous emphysema,2 cases converted to open operation for uncontrollable bleeding,1 case experienced postoperative adrenal crisis.The symptoms before operation was remission after 3 months.Conclusion:The improved perioperative management and skilled laparoscopic surgical technique is the key to success and reduce complications.