腹腔镜肾上腺切除术(附12例报告)

目的 探讨腹腔镜肾上腺切除术的临床价值。方法 分析腹腔镜肾上腺切除术12例的临床资料，其中经腹腔途径切除10例，经后腹腔途径切除2例。从手术的适应证、手术途径、手术方法及术后恢复等多方面进行讨论。结果 本组12例成功11例，1例中转开放。手术时间90～300min，平均130min。出血量20～200mL，平均出血量50mL。引流管1～30d拔除。术后住院6～30d，平均10d。术后并发症包括：胸腔积液1例，Trocar穿刺孔皮下组织脂肪液化和感染各1例。成功11例病理结果为：肾上腺嗜铬细胞瘤3例，功能性肾上腺皮质腺瘤4例(其中原醛症和皮质醇症各2例)，原醛腺瘤样增生1例，无功能肾上腺皮质腺瘤1例，肾上腺髓样脂肪瘤2例。中转开放1例为无功能肾上腺皮质腺瘤。结论 如能熟练操作腹腔镜，并选择合理的适应证，腹腔镜肾上腺切除术是首选的治疗方法。

Laparoscopic Adrenalectomy (Report of 12 Cases)

Purpose To evaluate the efficacy of laparoscopic adrenalectomy. Methods The clinical data of 12 cases of adrenal gland diseases treated with laparoscopic adrenalectomy form Dec. 2000 to May. 2002 was studied retrospectively. Results Eleven of 12 cases were successful, only one was converted to open surgery due to the pleural injury. In the success cases, the operating time was 90-300 min,mean 130 min. The bleeding volume being 20-200 mL,mean 50 mL. The postoperative hospitalization was 6-30 days, mean 10 days. The operative complications occurred in 3 cases. One was pleural hydrosis and the two others were Trocar port fat liquefaction and infection. The pathological study revealed that was pheochromocytoma (3),aldosteroma (2) ,Cushing's adenoma(2),aldosteronism of adenomatoid hyperplasia (1),nonfunctioning adenoma (1) ,myelolipoma (2). The unsuccessful case was nonfunctioning adenoma. Conclusions To be skilled with the laparoscopic technique and select suitable indication, laparoscopic adrenalectomy should be considered as the procedure of choice for the resection of most adrenal tumor.