经脐单孔多通道腹腔镜肾上腺肿瘤切除术的临床研究

目的:探讨经脐单孔多通道腹腔镜肾上腺肿瘤切除术的临床应用价值。方法:2009年4月～2009年11月,我院应用Triport单孔多通道平台完成6例肾上腺肿瘤切除术,其中右侧4例,左侧2例,平均肿瘤直径2.2(1.5～4.0)cm。结果:手术均顺利完成,其中2例在剑突下增加1个5 mm套管。平均手术时间115 min,出血80 ml;术后平均住院3.5(2～6)天。术后无明显手术瘢痕,美容效果良好。术后病理诊断为原发性醛固酮增多症3例,肾上腺皮质腺瘤3例。结论:经脐单孔多通道腹腔镜下肾上腺肿瘤切除术安全可行,但操作难度较大,暴露欠佳,手术时间明显长于传统腹腔镜手术,需要进一步研发新的手术器械以改善术中显露。

Clinic Study on Laparoscopic Adrenalectomy Performed Exclusively Through an Umbilical Incision Using a Single-port

Objective： To discussed the clinical value of laparoscopic adrenalectomy performed exclusively through an umbilical incision using a single-port. Methods： Since April to November, 2009, we have performed single port laparoscopic adrenalectomy in 6 patients diagnosed adrenal tumor, 4 in the right and 2 in the left, with a mean diameter 2.2 （1.5 4.0） cm. Results：All case were completed successfully, 1 trocar （5 mm） was added in only two patients. The total operative time was 115 min, the mean blood loss was 80ml, the hospital stay was 3.5 （2 6） days. There was no obviously scar and a good cosmetic result. Pathological diagnosis was primary aldosteronism in 3 cases, adrenal cortex adenoma in 3 cases. Conclusions： Single port laparoscopic adrenalectomy is feasible. But the procedure itself can be awkward at times due to the difficult exposure and operation. The new laparoscopic approach similar to any new technique, requires further experience to fully evaluate its benefit and limitations.