腹腔镜肾上腺切除术的临床应用

目的探讨腹腔镜技术在肾上腺手术中的临床应用价值。方法肾上腺占位性病变行腹腔镜肾上腺切除术126例，其中经腹腔途径1例，经腹膜后途径121例，经腹手助腹腔镜4例。结果腹腔镜下成功完成手术125例，中转开放手术1例。手术时间（72±25．1）min（40～175min）；术中出血量（54±32．6）mL（15～420mL）；无输血和严重并发症发生。术后住院时间（6．3±1．3）d（5～8d），随访（28．5±11．5）月（3～85月），所有患者影像学检查未见肿瘤复发或转移，功能性肿瘤患者的症状减轻或消失。结论腹腔镜肾上腺切除术创伤小，术中出血少，术后恢复快，是治疗大多数肾上腺占位性病变的首选术式。

Laparoscopic Adrenalectomy and its Clinical Application

Objective To study the clinical value of laparoscopy in adrenal surgery. Methods From December 2000 to October 2007, 126 cases with adrenal solid lesions were treated with laparoscopic adrenalectomy. The operations were performed via transperitoneal approach, retroperitoneal approach and hand-assisted transperitoneal approach in 1 case, 121 cases and 4 cases respectively. Results The operations were successfully accomplished in 125 cases, with 1 case was converted to open surgery. The mean operative time was 72±25. 1 rain （40±175 min）, the mean Mood loss was 54±32.6 mL（15±420 mL）, and the postoperative hospital stay was 6.3±1.3 d（5～8 d）. There were no blood transfusion and serious complications in the study. The mean follow-up time was 28.5±11.5 months（2～85 months）. Imaging examinations revealed no tumor recurrence and metastasis in all the patients. The symptoms of patients with functional tumor were alleviated or disappeared. Concltlsion Laparoscopic adrenalectomy generally makes the first choice for the treatment of adrenal solid lesions with its mini-invasion, less blood loss, and quick recovery.