后腹腔镜手术在肾上腺疾病中的应用(附53例报告)

目的：探讨后腹腔镜手术治疗肾上腺疾病的手术方法及临床效果。方法：采用后腹腔镜手术治疗肾上腺疾病53例，其中原发性醛固酮增多症32例（腺瘤26例，结节样增生6例），皮质醇增多症10例（腺瘤5例，皮质增生5例），无功能性腺瘤4例，肾上腺囊肿3例，嗜铬细胞瘤3例，肾上腺髓质增生1例。结果：全部手术成功，无严重并发症，手术时间40～180min，平均75min；术中出血均在50ml以下。患者术后12h～1天即可下床活动，1天恢复进食，术后住院4～12天，平均6.3天。结论：后腹腔镜手术具有安全有效、创伤小、疼痛轻、康复快、住院时间短等优点，可作为肾上腺良性疾病的首选手术方法。

Retroperitoneal laparoscopic surgery for adrenal diseases (Report of 53 cases)

Objective:To investigate the clinical results and methods of retroperitoneal laparoscopic surgery for adrenal diseases.Methods:Retroperitoneal laparoscopic adrenalectomy was performed on 53 patients with adrenal diseases, including 26 cases of aldosteronepreducing adenoma, 6 nodular hyperplasia, 5 Cushing's syndrome, 5 Cushing's disease, 4 nonfunctional adrenal adenoma, 3 adrenal cysts, 3 adrenal pheochromacytoma, 1 adrenal medullary hyperplasia.Results:All 53 cases succeeded uneventfully with no severe complications. The mean operation time was 75 minutes (40~180 min), and the estimated blood loss <50 ml with no need of transfusion. The postoperative hospital stay was 4~12 d with a mean of (6.3) d.Conclusions:Retroperitoneal laparoscopic surgery for adrenal diseases was safe and effective, less traumatic to the patients, with less postoperative discomfort and quicker recovery. The procedure should be the first choice of therapy for benign adrenal diseases.