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目的:评价腹腔镜治疗肾上腺嗜铬细胞瘤的疗效及安全性。方法:采用腹腔镜治疗肾上腺嗜铬细胞瘤31例。其中经后腹膜途径23例,经腹膜途径8例。结果:所有患者手术均获成功。术后病理诊断皆为嗜铬细胞瘤。有4例出现血压、心率剧烈波动,血压最高达210/110 mmHg,最低达到85/55 mmHg,心率最高达121次/min。其余患者手术过程中血压和心率平稳。术中出血量约为40-210 ml,平均(70±21)ml,无1例患者输血,手术时间50-135 min,平均(60±20)min。术后住院时间4-8 d,平均5.1 d。所有患者无明显并发症,无切口感染。术前内分泌检查尿香草苦杏仁酸(VMA)、肾上腺素(N)、去甲肾上腺素(NE)增高者,术后3个月复查已经恢复正常。术后随访3-24个月,未见症状复发以及肿瘤局部复发。结论:腹腔镜治疗肾上腺嗜铬细胞瘤具有相当高的安全性,充分的术前准备是手术成功的关键,术者可根据经验和肿瘤大小选择经腹入路腹腔镜手术或腹膜后入路腹腔镜手术。
Objective: To evaluate the efficacy and safety of laparoscopic treatment of adrenal pheochromocytoma. Methods: Laparoscopic treatment of adrenal pheochromocytoma in 31 cases. Among them, 23 cases were treated with retroperitoneal route and 8 cases were treated with peritoneal route. Results: All patients were successful in surgery. Postoperative pathological diagnosis of pheochromocytoma. There were 4 cases of blood pressure, heart rate fluctuations, blood pressure up to 210/110 mmHg, the lowest reached 85/55 mmHg, heart rate up to 121 beats / min. The remaining patients with stable blood pressure and heart rate during surgery. The intraoperative blood loss was about 40-210 ml, with an average of (70 ± 21) ml. No transfusion was performed in 1 patient. The operation time was 50-135 min with an average of (60 ± 20) min. Postoperative hospital stay 4-8 d, an average of 5.1 d. All patients without significant complications, no incision infection. Preoperative endocrine examination Urine vanilloid (VMA), epinephrine (N), norepinephrine (NE) were increased, 3 months after the review has returned to normal. All patients were followed up for 3-24 months. No recurrence of symptoms and local tumor recurrence were observed. Conclusion: Laparoscopic treatment of adrenal pheochromocytoma has a very high safety, adequate preoperative preparation is the key to the success of surgery, the surgeon can choose according to the experience and size of the tumor transabdominal laparoscopic or retroperitoneal approach abdominal cavity Mirror surgery.