后腹腔镜肾上腺手术经验体会(附186例报告)

目的总结后腹腔镜肾上腺切除术的体会并探讨其手术技巧。方法回顾分析自1997年4月~2003年6月该院利用后腹腔镜技术进行的186例肾上腺手术, 将2001年前进行的105例手术与其后进行的81例手术在患者年龄、病种、肿瘤大小、手术时间、术中出血量、术后平均住院日及术后平均下床时间和进食时间、术后并发症等各指标进行对比。结果两组手术在患者年龄、病种、肿瘤大小方面无差异(P>0.05),但在平均手术时间和术中平均出血量上取得明显进步(P<0.05),而术后平均住院日、术后平均下床时间和进食时间及术后并发症上无明显差异(P>0.05)。结论后腹腔镜肾上腺切除术手术入路直接,对患者创伤小,恢复快,提高手术技巧有助于缩短手术时间和减少术中出血。

Lessons learned from 186 retroperitoneal laparoscopic adreanlectomy

Objective: To summarize experiences in 186 cases of retroperitoneal laparoscopic surgery. Methods: From April 1997 to June 2003, retroperitoneal laparoscopic surgerys were performed for 186 cases of adrenal diseases. There were 105 cases before 2001 and 81 cases after that, to compare two groups in the gender, category of disease and mean size of tumor, to focus on the operating time, Intraoperative blood loss, first solid food day, ambulatory day and the complications. Results: There were no differents in the gender, category of disease and mean size of tumor between two groups (P >0.05), no different in the first solid food day, ambulatory day and the complications yet (P >0.05), whereas the operating time was shorten and the Intraoperative blood loss was decreased (P <0.05). Conclusions: Retroperitoneal laparoscopic surgery is less traumatic to the patients, with less postoperative discomfort and quick recovery and should be considered the first choice of therapy for adrenal disorders.