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目的:初步尝试采用单切口经腹膜内腹腔镜技术行肾上腺肿瘤切除,探讨其临床疗效及安全性,为进一步临床应用奠定基础。方法:采用经腹腔内途径单切口腹腔镜技术对3例肾上腺肿瘤患者行肿瘤切除术,术中选择腋前线肋缘下3cm切口,切口内置入3枚Trocar套管针,手术过程中使用Cambridge Endo头端可弯腹腔镜器械、超声刀技术、Hem-o-lok等对3例肾上腺肿瘤进行切除。结果:3例手术均取得成功,无中转开放或术中增加Trocar套管针辅助。手术时间分别为75、116、135min,平均(108.7±30.7)min,术中出血10、20、30ml,平均(20±10)ml,术后1d拔除胃管、导尿管,术后3d拔除腹腔引流管,术后住院时间均为4d。结论:单切口经腹膜内途径腹腔镜下肾上腺肿瘤切除术具有创伤小、出血少、安全性高、术后住院时间短的优点,但手术操作难度较大。
OBJECTIVE: To initially try to use a single incision laparoscopic intraperitoneal laparoscopic resection of adrenal tumors to explore its clinical efficacy and safety, and lay the foundation for further clinical application. Methods: Tumor resection was performed in 3 patients with adrenal neoplasm by intraperitoneal approach of single-incision laparoscopy. During operation, 3cm incision was made in the anterior axillary margin of axillary duct. Three Trocar trocars were inserted in the incision. The procedure was performed using Cambridge Endo Head flexible endoscopic instruments, ultrasound knife technology, Hem-o-lok, etc. 3 cases of adrenal tumors were resected. Results: All the three surgeries were successful, with no transit or open surgery or Trocar trocar support during operation. The operation time was 75,116,135min, mean (108.7 ± 30.7) min, intraoperative bleeding was 10,20,30ml, mean was (20 ± 10) ml. Gastric tube and catheter were removed on the first postoperative day, Abdominal drainage tube, postoperative hospital stay were 4d. Conclusions: Laparoscopic adrenalectomy with single incision and intraperitoneal route has the advantages of less trauma, less bleeding, higher safety and shorter postoperative hospital stay, but the surgical operation is more difficult.