层面解剖和程序化手术步骤在后腹腔镜肾上腺肿瘤切除术中的临床体会（附57例报告）

doi:10.19558/j.cnki.10-1020/r.2020.06.002

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摘要 目的： 探讨层面解剖和程序化手术步骤在后腹腔镜肾上腺手术中应用的效率及安全性。方法： 选取2016年9月–2018年5月收治的肾上腺肿瘤患者57例,分为对照组（37例,采用常规后腹腔镜肾上腺肿瘤切除术）和观察组（20例,采用层面解剖和程序化手术步骤行后腹腔镜肾上腺肿瘤切除术）,记录所有患者的手术时间、术中出血量、引流管拔除时间、住院时间、并发症发生率等并进行分析。结果： 所有患者肾上腺肿瘤切除手术均获成功,无中转开放。观察组手术时间明显短于对照组,差异有统计学意义（P<0.05）;对照组术后出现腹膜损伤2例,观察组无一例术后并发症。在术中出血量、术后胃肠功能恢复时间、引流管拔除时间、住院时间方面比较,两组差异无统计学意义（P>0.05）。结论： 应用层面解剖和程序化手术步骤的后腹腔镜肾上腺肿瘤切除术,术野暴露好,手术时间短,术后并发症发生率低,值得推广应用。

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	张伟
	施春梅
	朱华
	顾栋华
	潘晓东
	陈新凤
	郑兵

关键词 ：层面解剖, 程序化手术步骤, 肾上腺肿瘤切除术

Abstract：Objective： To explore the efficiency and safety of the application of slice anatomy and programmed procedures in posterior laparoscopic adrenal surgery. Methods： A total of 57 patients with adrenal tumors admitted to our hospital from September 2016 to May 2018 were selected and divided into a control group （37 cases undergoing conventional retroperitoneal laparoscopic adrenal tumor resection） and an observation group （20 cases receiving postoperative laparoscopic adrenal tumor resection using slice anatomy and programmed surgical procedures）. The operation time, intraoperative blood loss, drainage tube removal time, hospital stay, and complication rate were recorded and statistically analyzed. Results： All patients had successful resection of adrenal tumors, and there was no conversion to open surgery. The operation time in the observation group was significantly shorter than that in the control group （P < 0.05）. Two cases of peritoneal injury occurred in the control group, and there was no postoperative complications in the observation group. In terms of intraoperative blood loss, postoperative gastrointestinal function recovery time, drainage tube removal time, and hospital stay, there was no significant difference between the two groups （P > 0.05）. Conclusion： The posterior laparoscopic adrenal tumor resection with the application of slice anatomy and programmed surgical procedures has the advantages of fully surgical field exposure, short operation time, and low postoperative complication rate.

Key words： slice anatomy programmed surgical procedures adrenalectomy

收稿日期: 2019-12-27

ZTFLH:

R736.6

基金资助:2017江苏省科技项目（BE2017682）; 南通市卫生健康委课题（QA2019014）

通讯作者: 郑兵,ntzb2008@163.com

引用本文:

张伟, 施春梅, 朱华, 顾栋华, 潘晓东, 陈新凤, 郑兵. 层面解剖和程序化手术步骤在后腹腔镜肾上腺肿瘤切除术中的临床体会（附57例报告）[J]. 微创泌尿外科杂志, 2020, 9(6): 367-370.
ZHANG Wei, SHI Chunmei, ZHU Hua, GU Donghua, PAN Xiaodong, CHEN Xinfeng, ZHEN Bin. Clinical experience of the application of slice anatomy and programmed surgical procedures in retroperitoneal laparoscopic adrenalectomy (report of 57 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(6): 367-370.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1630.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I6/367