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目的:总结后腹腔镜手术治疗肾上腺肿瘤的临床经验。方法:回顾性分析我科2008-07-01-2011-12-31行后腹腔镜手术治疗的327例肾上腺良性肿瘤病例的临床资料,其中原发性醛固酮增多症167例,皮质醇增多症79例,嗜铬细胞瘤21例,无功能肾上腺皮质腺瘤52例,肾上腺囊肿8例。对肾上腺病变类型、后腹腔镜手术的时间、出血量、并发症和预后进行总结,并对手术方法进行分析。结果:326例手术成功,1例中转开放手术。手术时间33～235min,平均66.1min;术中出血量25～950mL,平均72.6mL;术后平均住院时间5.7d。术后并发症:腹膜损伤12例,皮下气肿9例,伤口延迟愈合7例,腰部血肿5例,右肾静脉损伤1例。结论:后腹腔镜下肾上腺手术治疗安全有效,是肾上腺良性肿瘤的首选治疗方式。
Objective: To summarize the clinical experience of retroperitoneal laparoscopic surgery for adrenal tumors. Methods: The clinical data of 327 cases of benign adrenal tumors treated with retroperitoneal laparoscopic surgery were retrospectively analyzed. Among them, 167 cases were primary aldosteronism, 79 cases were corticosteroid 79 Cases, pheochromocytoma in 21 cases, 52 cases of non-functioning adrenal adenoma, adrenal cysts in 8 cases. The types of adrenal lesions, laparoscopic surgery time, bleeding, complications and prognosis were summarized, and the surgical methods were analyzed. Results: 326 cases were successful and 1 case was transferred to open surgery. The operation time was 33 ~ 235min with an average of 66.1min. The intraoperative blood loss was 25 ~ 950mL with an average of 72.6mL. The average postoperative hospital stay was 5.7d. Postoperative complications: 12 cases of peritoneal injury, subcutaneous emphysema in 9 cases, delayed wound healing in 7 cases, 5 cases of lumbar hematoma, 1 case of right renal vein injury. Conclusion: Retroperitoneal laparoscopic adrenalectomy is safe and effective and is the first choice of treatment for benign adrenal tumors.