腹腔镜术与开放手术在肾上腺髓质脂肪瘤治疗中的对比研究

目的：比较与评价腹腔镜与开放手术在治疗肾上腺髓质脂肪瘤中的临床价值。方法：回顾性分析47例接受腹腔镜术和开放手术治疗的肾上腺髓质脂肪瘤患者临床资料，统计分析这两种术式在手术时间、术中出血量、术后肠功能恢复时间、术后住院时间及并发症发生率等方面的差异。结果：37例接受腹腔镜术的患者，除1例因肾周脂肪层过厚、分离困难而中转开放手术外．其余均获得成功。10例接受开放手术的患者均获得成功。两组平均手术时间、平均手术出血量、术后肠功能恢复时间及术后住院天数分别为（128．3±49．6）min和（140．5±43．9）min，（53．3±57．1）ml和（145．5±110．5）ml，（2．1±0．7）天和（2．9±0．7）天，（5．6±1．0）天和（10．7±4．9）天。结论：腹腔镜肾上腺髓质脂肪瘤切除术在手术时间、术中出血量、术后肠功能恢复时间、术后住院时间等方面均优于开放手术，并发症发生率也低于开放手术，可作为肾上腺髓质脂肪瘤外科手术的首选治疗方法。

Comparative Study on Laparoscopic and Open Adrenalectomy for Adrenal Myelolipoma

Objective：To compare and evaluate the clinical value between laparoscopic adrenalectomy and open adrenalectomy for adrenal myelolipoma as the treatment of adrenal diseases. Methods：The clinical data of 37 cases underwent laparoscopic adrenectomy and 10 cases underwent open adrenalectomy were analyzed retrospectively. The differences in operating time, average bleeding volume during operation, hospitalization stay after operation. recovery time of GI function of the two procedures were compared. Results：In 37 laparoscopic adrenectomies 1 were converted to open surgery due to the thickness of perirenal fat layer, others were succeed. The mean operation time, average bleeding volume during operation, recovery time of GI function, hospitalization stay after operation of the laparoscopic group and open surgery group were： （128.3±49.6）min vs（140.5±43.9）min,（53.3±57.1）ml vs （145.5±110.5）ml, （2.1±0.7）days vs（2.9±0.7）days, （5.6±1.0） days vs（10.7±4.9）days, respectively. Conclusions：In laparoscopic adrenalectomy group, the operation time, average bleeding volume during operation, hospitalization stay after operation, recovery time of GI function and occurrence of complication were superior to those in the open adrenalectomy group. Retroperitoneal laparoscopic adrenaleetomy would become the first choice of the adrenal myelolipoma surgery.