经腹路径腹腔镜解剖性逆行肾上腺切除术的临床研究
Transperitoneal laparoscopic anatomic retro-adrenalectomy
目的 介绍改进的经腹路径腹腔镜解剖性逆行肾上腺切除术的手术技巧和临床经验。 方法 回顾性分析2009年1月至2013年1月间行经腹路径腹腔镜解剖性逆行肾上腺切除术47例患者的临床资料, 并与同期采用后腹腔镜肾上腺手术36例的临床结果进行比较。 结果 经腹路径腹腔镜解剖性逆行肾上腺切除组均取得成功。与后腹腔镜组相比,此术式可明显缩短手术时间(45.6±23.4 min vs.115.5±18.2 min);减少术中出血量(25.3±10.6 ml vs.110.6±30.3 ml)。组间比较差异有显著性意义(P<0.001)。无术后并发症发生(0 vs.13.8%)。 结论 经腹路径腹腔镜解剖性逆行肾上腺切除术分离组织范围小,定位、切除肾上腺快捷,术中出血少,是肾上腺良性病变可靠、安全的腹腔镜手术方式。
Objective To introduce the surgical skill and clinical experience of transperitoneal laparoscopic anatomic retro-adrenalectomy. Methods From January 2009 to January 2013, 47 patients underwent transperitoneal laparoscopic anatomic retro-adrenalectomy. Also, 36 patients underwent posterior laparosciopic adrenalectomy. Clinical data and surgical outcomes were compared retrospectively. Results Patients in the transperitoneal laparoscopic anatomic retro-adrenalectomy group were all successful in surgery. There was significant difference in mean operative time(45.6±23.4 min vs.115.5±18.2 min)and intraoperative blood loss(25.3±10.6 ml vs.110.6±30.3 ml)(P<0.001). No postoperative complications occurred in the transperitoneal laparoscopic anatomic retro-adrenalectomy group(0 vs.13.8%). Conclusions The key advantage to this technique is its minimally invasive approach, shortened surgical time and reduced blood loss. We believe this approach to be a viable and safe option in the removal of benign adrenal lesions.
Transperitoneal laparoscopy / Adrenalectomy / Applied anatomy
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国家高技术研究发展计划(863计划)资助项目(2007AA022006)
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