腹腔镜手术切除巨大肾上腺肿瘤的临床探讨

目的：探讨腹腔镜手术切除巨大（直径≥8cm）肾上腺肿瘤的可行性。方法：采用经腹途径腹腔镜切除术治疗巨大肾上腺肿瘤患者6例，左侧4例，右侧2例，肿瘤最大径8．5～12cm。结果：6例腹腔镜手术均获得成功，无中转开放手术。手术时间平均120min（90～185min），术中出血量平均150ml（50～400m1）。术后胃肠功能恢复时间1～2天，术后2～3天拔除引流管，术后住院6～lO天。随访4～24个月，未发现异常。病理检查报告肾上腺嗜铬细胞瘤2例，神经节细胞瘤1例，神经鞘瘤1例，髓性脂肪瘤2例。结论：肿瘤大小并不是选择腹腔镜手术的决定性因素。在技术娴熟的条件下，腹腔镜治疗巨大肾上腺肿瘤是安全、可行的。

Laparoscopic Adrenalectomy for Large Adrenal Tumors

Objective：To evaluate the feasibility of laparoscopic adrenalectomy for large（= 8 cm in diameter） adrenal tumors. Mcthods：Transperitoneal laparoscopic adrenalectomy was performed on 6 patients with large adrenal tumor,4 of them on the left side and the others on the right side. The largest diameter of tumors were from 8. 5 to 12 cm. Results：Transperitoneal laparoscopic surgery were performed successfully in all eases without conversion to open surgery. The mean operation time was 120 rain（range,90 to 185 min） ,and the mean blood loss was 150 ml（range,50 to 400 ml）. Drainage tube was removed at 2 or 3 days post-operation and postoperative hospital stay was 6-8 days. During the 4-24 months followup,no cases were found recurrent and metastases. Pathological diagnosis include pheochromocytoma in 2, adrenal gangliocytoma it） 1, adrenal neurinoma in 1, adrenal medullalipoma in 2. Conclusions： Laparoscopic adrenalectomy is feasible and safe for patients with large adrenal tumors as long as no contraindication of the surgery is found. The diameter of the tumor does not determine the surgery feasibility.