单孔后腹腔镜与传统后腹腔镜肾上腺肿瘤切除术的比较研究

目的 探讨单孔后腹腔镜肾上腺肿瘤切除术的优缺点.方法 回顾分析2010年1月~2013年6月单孔后腹腔镜肾上腺肿瘤切除术（单孔组,n=17）及2008年1月~2009年12月传统三孔法后腹腔镜肾上腺肿瘤切除术（三孔组,n=15）的临床资料.对比2组手术时间、术中出血量、术后住院时间、术后疼痛指数、手术美容满意度.结果 32例手术均顺利完成,无中转手术,无并发症.单孔组美容满意度高（Kiyak评分91.5±3.5 vs.89.2±2.8,t=2.100,P=0.044）,但手术时间长（86.9±17.6） min vs.（62.4±8.0） min,t=4.957,P=0.000],其他指标差异均无显著性（P＞0.05）.结论 单孔后腹腔镜肾上腺肿瘤切除术安全可行,能够取得和传统后腹腔镜肾上腺肿瘤切除术相同的临床效果,并且美容效果更好.但手术操作要求高,需经一定量的练习方能熟练掌握.

Comparison of Single-site and Conventional Retroperitoneal Laparoscopic Adrenalectomy

Objective To compare the clinical efficacy of retroperitoneal laparoscopic adrenalectomy with single-site surgery and conventional surgery. Methods From January 2010 to June 2013, 17 patients underwent single-site retroperitoneal laparoscopic adrenalectomy, and from January 2008 to December 2009, 15 patients underwent conventional 3-port retroperitoneal laparoscopic adrenalectomy. The operation time, the intraoperative blood loss, the postoperative hospital stay, the postoperative pain score, the cosmetic results were compared between the two groups. Results All the operations were completed successfully without major surgical complications or conversion to open surgery in both groups. The cosmetic results of the single-site group were better than the conventional group （Kiyak score： 91.5 ± 3.5 vs. 89.2 ± 2.8, t = 2. 100, P = 0. 044）, but the operation time of the single-site group was longer than the conventional group （86.9 ±17.6） min vs. （62.4 ±8.0） min, t =4.957, P =0.000]. No significant differences were found in other aspects between the two groups （ P 〉 0. 05 ）. Conclusions The single-site retroperitoneal laparoscopic adrenalectomy is safe and feasible. It has the same clinical effect as the conventional laparoscopic surgery and has better cosmetic results. However, the single-site surgery is demanding for the operator and requires ample practice.