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目的:总结后腹腔镜下肾上腺肿瘤切除的临床经验,评估后腹腔镜治疗肾上腺肿瘤的安全性、有效性及手术适应证。方法:回顾分析后腹腔镜技术下行肾上腺肿瘤切除51例,其中肾上腺皮质腺瘤24例,嗜铬细胞瘤16例,肾上腺皮质增生3例,肾上腺囊肿2例,肾上腺髓性脂肪瘤3例,神经鞘瘤1例,肾上腺皮质癌1例,肾上腺血肿1例。其中肾上腺腺瘤直径大小为1.2-5.5cm。嗜铬细胞瘤直径大小约为3.3-9.8cm。结果:49例患者手术均在后腹腔镜下顺利完成。2例因出血中转为开放。手术时间70-240min。术中出血量30-300ml,均未输血。术后2-4天患者恢复肠蠕动后进食,平均住院时间为5-10天。结论:后腹腔镜下切除肾上腺肿瘤具有出血少、恢复快的优点,充分的术前准备及娴熟的镜下操作技术、扎实的镜下解剖基础是手术成功的关键,较大肿瘤不应成为手术禁忌症。
OBJECTIVE: To summarize the clinical experience of laparoscopic adrenalectomy and evaluate the safety, efficacy and surgical indications of retroperitoneal laparoscopic treatment of adrenal tumors. Methods: Retrospective analysis of retroperitoneal laparoscopic ablation of adrenal tumors in 51 cases, of which 24 cases of adrenocortical adenoma, 16 cases of pheochromocytoma, adrenal hyperplasia in 3 cases, 2 cases of adrenal cysts, adrenal myeloma 3 cases, nerve 1 case of sheath tumor, 1 case of adrenocortical carcinoma and 1 case of adrenal hematoma. Adrenal adenoma which diameter size of 1.2-5.5cm. Pheochromocytoma diameter of about 3.3-9.8cm. Results: All the 49 patients underwent laparoscopic surgery successfully. 2 cases turned to open due to bleeding. Surgery time 70-240min. Intraoperative blood loss 30-300ml, no blood transfusion. 2-4 days after surgery, patients with bowel movements restored after eating, the average hospital stay of 5-10 days. Conclusions: Retroperitoneal laparoscopic resection of adrenal tumors has the advantages of less bleeding, faster recovery, adequate preoperative preparation and skilled operation of the microscope. A solid anatomic basis for microscopic dissection is the key to successful operation. Larger tumors should not become an operation Contraindications.