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本文报告经前腹腔镜途径的肾上腺肿瘤摘除术8例.患者男性7例,女性1例,年龄21～65岁.右肾上腺肿瘤切除6例,左肾上腺肿瘤切除2例(原发性醛固酮增多症6例,柯兴氏症1例,肾上腺皮质增生1例).本组病例均经前腹腔镜途径进行.该手术的关键在于肾上腺肿瘤的寻找与细心地止血,在肾上极内、前面周围脂肪堆中分离寻找肾上腺及肿瘤,遇有血管时,则用钛夹阻断;右侧分离时应注意避免损伤腔静脉,十二指肠.左侧应注意脾脏及胰尾.一般而言,肿瘤与正常肾上腺组织分界明显,易于被剥离.增生则宜作肾上腺大部切除术.该组病例无术中及术后并发症,术后恢复迅速.
This article reports 8 cases of preoperative laparoscopic adrenal neoplasms enucleation. 7 male patients and 1 female, aged 21 to 65 years. 6 cases of right adrenal tumor resection and 2 cases of left adrenal tumor resection (primary aldosteronism 6 cases, 1 case of Cushing’s disease, 1 case of adrenocortical hyperplasia). This group of cases were performed by anterior laparoscopic approach. The key to this operation is the search for adrenal tumors and careful hemostasis, in the upper pole of the kidney, in front of the surrounding Separation of adrenal glands and tumors in fat reactors. In the event of blood vessels, titanium clips are used to block them. In the right side, care should be taken to avoid damage to the vena cava and the duodenum. The left side should pay attention to the spleen and pancreas tail. In general, The tumor and normal adrenal tissue are clearly demarcated, and are easy to be stripped. Hyperplasia is advisable for adrenalectomy. There is no intraoperative and postoperative complications in this group of patients, and the recovery is rapid after surgery.