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目的 评价后腹腔镜及腹腔镜行肾上腺肿瘤切除术的临床价值。 方法 回顾性分析自 1996年 1月～ 1999年 8月经后腹腔镜肾上腺肿瘤切除术 8例 (A组 )及经腹腔腹腔镜肾上腺肿瘤切除术 12例 (B组 )的临床资料 ,并就二组手术时间、术中出血量、术后肠功能恢复情况及平均住院日等指标进行比较。 结果 切除肿瘤平均重量A组 >B组 ,而平均手术时间和术中平均出血量A组比B组分别缩短 2 3min和减少 15 .8ml,术后肠功能平均恢复时间和术后平均住院日A组比B组分别提前 0 .2 5天和减少 1.6天。但二组各项指标结果比较差别无显著性意义 (P >0 .0 5 )。 结论 腹腔镜肾上腺肿瘤切除术经后腹腔途径优于经腹腔途径。除肿瘤直径 >6cm、伴有心脑损害及位于肝后方或下腔静脉后方的嗜铬细胞瘤、体胖的皮质醇腺瘤外 ,均为腹腔镜手术适应证。
Objective To evaluate the clinical value of laparoscopic and laparoscopic adrenalectomy. Methods The clinical data of retroperitoneoscopic adrenal tumor resection in 8 cases (A group) and laparoscopic adrenal tumor resection in 12 cases (B group) from January 1996 to August 1999 were retrospectively analyzed. The operative time, intraoperative blood loss, postoperative recovery of intestinal function, and mean length of stay were compared. Results The average weight of tumors was removed in group A>B group, and the average operation time and mean intraoperative blood loss were shortened by 23 min and 15.8 ml respectively in group A compared with group B. The average recovery time of postoperative bowel function and postoperative average length of stay A The group was 0. 25 days earlier and 1.6 days less than Group B. However, there was no significant difference in the results between the two groups (P > 0.05). Conclusion The laparoscopic adrenal tumor resection is superior to the transperitoneal approach in the abdominal cavity. Except for tumor diameter >6cm, accompanied by heart and brain damage, and pheochromocytomas located behind the posterior hepatic vein or inferior vena cava, cortisol adenomas with body fat were all indications for laparoscopic surgery.