经腹腹腔镜手术治疗大体积(>6 cm)嗜铬细胞瘤的临床分析

doi:10.19558/j.cnki.10-1020/r.2018.05.003

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摘要目的探讨经腹腹腔镜治疗大体积(>6 cm)嗜铬细胞瘤的安全性和效果。方法回顾性分析21例接受腹腔镜手术治疗的大体积嗜铬细胞瘤患者的临床资料,患者年龄27~66岁,平均(47.8±11.5)岁。左侧14例,右侧7例,最大径6.3~14.5 cm,平均(8.5±2.3)cm,所有病例术前给予20~60 mg/d 酚苄明准备2~4周。结果所有病例均采用经腹腹腔镜肾上腺肿瘤切除术,2例因与肝脏、下腔静脉粘连而改为开放手术,手术时间分别为260和300 min,出血量分别为800和1 000 ml;余病例手术时间115~230 min,平均(160.7±33.2)min。术中出血量70~360 ml,平均(124.1±71.5)ml。21例术后住院7~10 d,平均(8.2±0.9)d,无严重并发症。随访6~60个月,1例出现腹盆腔转移,死于术后13个月。结论在良好的术前准备和细心的术中操作前提下,经腹腹腔镜肾上腺肿瘤切除术是治疗大体积嗜铬细胞瘤的安全选择。

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	杨风光
	黄超
	许清江
	魏永宝
	朱庆国
	叶烈夫
	高祥勋

关键词 ：肾上腺切除术, 肾上腺, 腹腔镜, 嗜铬细胞瘤

Abstract：Objective:To evaluate the efficancy and safety of transperitoneal laparoscopic adrenalectomy for large pheochromocytoma (with diameter greater than 6 cm). Methods:A restrospective analysis was performed on 21 patients who underwent laparoscopic adrenalectomy for large pheochromocytoma. All patients were prepared by 20-60 mg dose of phenoxybenzamine per day for 2 to 4 weeks before the surgery. Results:The mean age was (47.8±11.5) years (range 27-66). There were 14 cases of lesions located in left side and 7 cases in opposite. The mean diameter was (8.5±2.3) cm (range: 6.3-14.5 cm). All cases were treated with transperitoneal laparoscopic adrenalectomy and two of them were converted to open operation due to adhesion to liver and inferior vena cava. The mean surgical time was (160.7±33.2) min (range: 115 to 230 min). The volume of hemorrhage was (124.1±71.5) mL (range: 70 to 360 mL). For two open cases, surgical time were 260 and 300 min ,and the volumn of hemorrhage were 800 and 1 000 mL respectively. The mean hospital stay after operation was (8.2±0.9) days (range: 7 to 10 days), and no major intraoperative complications occured. All cases were follewed up for 6 to 60 months, and one patient was recurred with abdomen metastasis and died in 13 months after operation. Conclusions:With adequately preoperative preparation and carefully intraoperative manipulation, transperitoneal laparoscopic adrenalectomy could be a safe and minimally invasive procedure for large pheochromocytoma.

Key words： adrenalectomy adrenal gland laparoscopy pheochromocytoma

收稿日期: 2017-09-15

ZTFLH:

R737.11

通讯作者: 杨风光,frankle_yang@126.com

引用本文:

杨风光, 黄超, 许清江, 魏永宝, 朱庆国, 叶烈夫, 高祥勋. 经腹腹腔镜手术治疗大体积(>6 cm)嗜铬细胞瘤的临床分析[J]. 微创泌尿外科杂志, 2018, 7(5): 297-301.
Yang Fengguang, Huang Chao, Xu Qingjiang, Wei Yongbao, Zhu Qingguo, Ye Liefu, Gao Xiangxun. Clinical Analysis of transperitoneal laparoscopic adrenalectomy for large (>6 cm) pheochromocytoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(5): 297-301.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1440.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2018/V7/I5/297

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