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目的:探讨使用常规腹腔镜器械经后腹膜腔行单切口多通道肾上腺肿瘤切除术的可行性和安全性。方法:选取我院自2011年10月~2013年6月收治的肾上腺肿瘤患者12例,男6例,女6例,年龄35~60岁,平均42.6岁。肿瘤最大径1.5~3.5cm,平均2.8cm。肿瘤位于右侧5例,左侧7例。在腋中线髂脊上3~4cm做直径长约3cm半圆形切口,应用常规腹腔镜器械行单切口多通道后腹腔镜肾上腺肿瘤切除术。结果:12例患者手术均获成功,无一例中转开放手术。手术时间90~120min,平均106min。出血量50~150ml,平均95ml。术后引流管留置时间1~3d。术后平均住院时间4~6d。所有患者术后未使用镇痛药物。术后病理检查报告为嗜铬细胞瘤3例,皮质腺瘤9例。结论:应用常规腹腔镜器械经后腹膜腔行单切口多通道肾上腺肿瘤切除术安全有效,不仅具有传统腹腔镜手术的优点,还可以减少手术费用及手术创伤,并具有一定美容效果。
Objective: To investigate the feasibility and safety of single laparoscopic multi-channel adrenalectomy using retroperitoneal laparoscopic instruments. Methods: Twelve patients with adrenal tumors admitted to our hospital from October 2011 to June 2013 were selected, including 6 males and 6 females, aged 35-60 years (average 42.6 years). The largest tumor diameter 1.5 ~ 3.5cm, an average of 2.8cm. The tumor was located on the right side in 5 cases and on the left side in 7 cases. In the axillary midline iliac spine 3 ~ 4cm diameter of about 3cm semi-circular incision, the use of conventional laparoscopic single-incision multi-laparoscopic retroperitoneal laparoscopic adrenalectomy. Results: All the 12 patients were successful in operation. None of them underwent open surgery. Surgery time 90 ~ 120min, an average of 106min. Bleeding volume 50 ~ 150ml, an average of 95ml. Postoperative drainage tube indwelling time 1 ~ 3d. The average postoperative hospital stay 4 ~ 6d. All patients did not use analgesics after surgery. Postoperative pathological examination reported pheochromocytoma in 3 cases, 9 cases of cortical adenoma. Conclusion: It is safe and effective to use conventional laparoscopic trans-peritoneal multi-channel adrenalectomy with single incision. It not only has the advantages of traditional laparoscopic surgery, but also can reduce the operation cost and surgical trauma and has a certain cosmetic effect.