腹腔镜手术治疗原发性醛固酮增多症

目的探讨原发性醛固酮增多症（PA）的腹腔镜微创手术治疗效果。方法2009年7月至2011年7月对商丘市第一人民医院20例PA采用腹腔镜治疗，其中肾上腺皮质腺瘤17例，肾上腺皮质增生3例。结果平均手术时间63（35—95）min，平均术中失血量50（25～110）ml，平均术后住院5．8（4—8）d。术中、术后发生并发症2例，均为轻度皮下气肿。20例平均随访12（6～18）个月，血钾均恢复正常，3例仍有高血压需辅以降压药物治疗。结论腹腔镜手术肾上腺部分切除／肿瘤剜除术或全切治疗PA具有创伤小、安全、疗效肯定等优点，宜为该类疾病的首选治疗。

The laparoscopic surgical treatment of primary aldosteronism

Objective To investigate the effect of laparoscopic surgery on primary aldosteronism （PA）. Methods 20 cases of PA treated by laparoseopic surgery from Jul. 2009 to Jul. 2011 were retrospectively analyzed, among whom 17 cases had adrenocortical adenoma and 3 cases had adrenal cortical hyperplasia. Results The mean surgical time was 63 （35 - 95 ）min, the mean intraoperative blood loss was 50 （25 - 110）ml, and the mean hospital stay was 5.8 （4 - 8 ）d. Complication during or after surgery happened to 2 patients. They are both with light cutaneous emphysema. During the medium follow-up of 12 （6 - 18 ）months, serum potassium levels of all patients were normal, and 3 patients with high blood pressure still need hypotensive drug. Conclusion Laparoscopic resection of the whole or partial adrenal tumor is minimally invasive, safe and with confirmed effects, making it the preferred method for PA.