后腹腔镜手术治疗原发性醛固酮增多症133例临床体会

目的：探讨原发性醛酮增多症的后腹腔镜微创手术治疗效果。方法：2002年9月～2006年9月对133例原发性醛固酮增多症患者采用经腹膜后入路腹腔镜治疗，其中肾上腺皮质腺瘤126例，肾上腺皮质增生7例。结果：手术平均时间93min，术中平均失血量36mL，术后平均住院时间6．8d。术中、术后发生并发症16例，9例腹膜破损，7例轻度皮下气肿。115例平均随访20个月，所有患者血钾恢复正常．术后30例仍有高血压需辅以降压药物治疗。结论：腹膜后入路腹腔镜肾上腺全切术或部分切除／肿瘤切除术治疗原发性醛固酮增多症具有微创、安全、疗效确切的优点，将成为该病治疗的首选术式。

Treatment of primary aldosteronism with retroperitoneal laparoscopic surgery

Objective: To investigate the effect of retroperitoneal laparoscopic surgery on primary aldosteronism.Methods: Retrospectively analyzed 133 cases with primary aldosteronism treated by retroperitoneal laparoscopic surgery from Sep.2002 to Sep.2006,including 126 patients with adrenocortical adenoma and 7 patients with adrenal cortical hyperplasia.Results: Mean surgical time was 93min,mean blood loss was 36mL during surgery,and mean hospital stay was 6.8d.16 patients had complication during or after surgery,including 9 cases with broken abdominal membrane,7 cases with light cutaneous emphysema.20-month follow-up of 115 cases showed that serum potassium levels of all patients were normal,and 30 patients with high blood pressure still need hypotensive drug.Conclusion: Retroperitoneal laparoscopic surgery of whole or partial adrenal tumor is minimally invasive,safe and with confirmed effect.It will become preferred surgery for primary aldosteronism.