论文部分内容阅读
目的:总结既往有肾上腺手术史者再行腹腔镜肾上腺手术的经验。方法:2005年5月～2007年3月采用腹腔镜经腹腔途径对3例肾上腺肿物切除术后患者再行腹腔镜肾上腺肿物切除术。3例原发性醛固酮增多症患者均为女性,平均48岁(35～56岁),左侧1例,右侧2例,肿瘤平均直径1.4 cm(1.2～2.0 cm),2例曾行腹腔镜经后腹腔肾上腺肿物切除,1例曾行经腰切口开放肾上腺肿物切除。观察手术时间、术中出血量、住院天数、并发症及手术效果。结果:3例手术均顺利完成。平均手术时间90 min(75～110 min),术中平均出血量20ml(10～30 ml)。平均住院时间5天(4～6天),术中术后无并发症发生。随访8～25个月肿瘤无复发。结论:对于有肾上腺手术史者再行腹腔镜肾上腺手术难度增加,但腹腔镜再次手术是可行有效的。
OBJECTIVE: To summarize the experience of previous laparoscopic adrenal surgery with a history of adrenal surgery. Methods: From May 2005 to March 2007, laparoscopic transabdominal approach was used to perform laparoscopic adrenalectomy in 3 patients after adrenalectomy. Three patients with primary aldosteronism were female, average 48 years (range 35-56 years). There were 1 case on the left and 2 cases on the right. The mean diameter of the tumors was 1.4 cm (1.2-2.0 cm) After transabdominal adrenal resection of the mirror, 1 case had undergone incision open adrenal resection. Observation of operation time, intraoperative blood loss, hospitalization days, complications and surgical results. Results: All 3 cases were successfully completed. The average operation time was 90 min (75-110 min). The mean intraoperative blood loss was 20 ml (10-30 ml). The average hospital stay of 5 days (4 to 6 days), no postoperative complications. Follow-up 8 to 25 months without recurrence of the tumor. Conclusions: Laparoscopic adrenal surgery is more difficult for patients with adnexal surgery, but laparoscopic reoperation is feasible and effective.