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目的:探讨经后腹腔镜手术治疗直径≥6.0cm的肾上腺肿瘤的安全性和效果。方法:对我院近5年收治经后腹腔镜手术治疗的直径≥6.0cm肾上腺肿瘤患者的临床资料进行回顾分析,27例患者年龄24~76岁,男性10例,女性17例,肿瘤直径6.0~8.5 cm。病理结果为:髓质脂肪瘤9例,肾上腺皮质腺瘤7例,肾上腺嗜铬细胞瘤6例,节细胞神经瘤3例,肾上腺皮质腺癌1例,肾上腺转移瘤1例。结果:24例患者顺利切除肿瘤,另外3例患者术中转开放手术,平均手术时间(119.46±36.65)min,术中估计出血量(80.14±36.48)mL,术后进食时间(1.88±0.82)d,术后引流管留置时间(2.05±0.65)d,术后住院时间(6.21±1.84)d。结论:在技术熟练的前提下,直径≥6.0 cm的肾上腺肿瘤经后腹腔镜手术治疗仍然安全、微创。
Objective: To investigate the safety and efficacy of retroperitoneal laparoscopic surgery for adrenal tumors of diameter ≥6.0cm. Methods: The clinical data of patients with adrenal tumors> 6.0cm in diameter treated by retroperitoneal laparoscopic surgery in our hospital during the past 5 years were retrospectively analyzed. Twenty-seven patients were aged 24 to 76 years old. There were 10 males and 17 females with a diameter of 6.0 ~ 8.5 cm. Pathological findings were: medullary lipoma in 9 cases, adrenal cortical adenoma in 7 cases, adrenal pheochromocytoma in 6 cases, 3 cases of ganglioneuroma, adrenocortical adenocarcinoma in 1 case, adrenal metastases in 1 case. Results: Twenty-four patients underwent successful resection of the tumor. The other three patients underwent open surgery. The mean operative time (119.46 ± 36.65) min, intraoperative blood loss (80.14 ± 36.48) mL and postoperative ingestion time (1.88 ± 0.82) d , Postoperative drainage tube indwelling time (2.05 ± 0.65) d, postoperative hospital stay (6.21 ± 1.84) d. CONCLUSIONS: Adrenal tumors ≥6.0 cm in diameter are safe and minimally invasive with retroperitoneal laparoscopic surgery under technically proficient conditions.