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目的:总结经脐单孔腹腔镜下行肾上腺部分切除术治疗肾上腺腺瘤的临床经验并探讨其可行性。方法:2009年10月～2011年1月采用自制的多通道单孔设备对6例肾上腺腺瘤患者行经脐单孔腹腔镜下肾上腺部分切除术,腺瘤直径(2.3±0.5)cm。脐部作1～2 cm弧形切口,置入自制多通道单孔设备、普通腹腔镜及可弯器械,切开后腹膜,于肾上极内侧游离肾上腺肿瘤,完整切除腺瘤,尽可能保留正常肾上腺。结果:6例手术均顺利完成,手术时间(123.3±23.4)min,,出血量平均(86.5±12.4)ml。术后有1例患者血压较高,采用降压药物后控制,其余均无高血压及肾上腺危象表现,血钾均恢复至正常水平。住院时间平均3天。术后病理检查证实为肾上腺腺瘤。6例随访3～12个月,脐部切口愈合良好,无脐疝等并发症。复查B超及腹部CT均无复发。结论:采用自制的多通道设备行经脐单孔腹腔镜下肾上腺部分切除安全、可行,瘢痕隐蔽,美容效果好,是临床治疗肾上腺腺瘤的一个新选择。
OBJECTIVE: To summarize the clinical experience and the feasibility of transabdominal single-hole laparoscopic adrenalectomy for adrenal adenoma. Methods: From October 2009 to January 2011, 6 patients with adrenal adenomas underwent laparoscopic partial laparoscopic adrenalectomy using a homemade multi-channel single-hole device. The diameter of adenomas was (2.3 ± 0.5) cm. The umbilicus for 1 ~ 2 cm curved incision, home made multi-channel single hole equipment, ordinary laparoscopic and flexible instruments, incision of the peritoneum, the medial renal adrenal free adrenal tumor, complete resection of adenomas, as far as possible retained Normal adrenal gland Results: All the 6 cases were successfully completed. The operation time (123.3 ± 23.4) min and the mean amount of bleeding were (86.5 ± 12.4) ml. One patient had high blood pressure after surgery and was controlled by antihypertensive drugs. The remaining patients showed no symptoms of hypertension and adrenal crisis, and both of them recovered to their normal levels. Hospitalized an average of 3 days. Postoperative pathology confirmed adrenal adenoma. 6 cases were followed up for 3 to 12 months, umbilical incision healing well, no complications such as umbilical hernia. Review B ultrasound and abdominal CT no recurrence. Conclusion: It is safe and feasible to use laparoscopic partial laparoscopic adrenalectomy through a homemade multi-channel device. It is a new choice for the clinical treatment of adrenal adenoma.