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目的:评价后腹腔镜行肾上腺嗜铬细胞瘤切除术的安全性。方法:对肾上腺嗜铬细胞瘤后腹腔镜切除术9例(A组),腹膜后开放手术15例(B组)的临床资料进行回顾分析,对手术时间、术中出血量、术中输血率、术后肠道恢复时间、术后住院时间、术中、术后并发症以及手中各时点的血压、心率情况和术中血流动力学不稳定事件的发生率进行对比并做统计学分析。结果:A组手术时间长于B组,差异有统计学意义(P<0·05)。两组间出血量、输血率、术后肠道恢复时间、总并发症率、术中及术后并发症率差异没有统计学意义(P>0·05)。A组术后住院时间短于B组,差异有统计学意义(P<0·05)。两组收缩压、舒张压、心率在术中各时间点的差异均没有统计学意义(P>0·05)。两组间在心动过速、低血压及血流动力学不稳定事件发生率方面的组间差异均也没有统计学意义(P>0·05)。结论:后腹腔镜肾上腺切除可缩短术后住院时间,不增加并发症发生率,并且术中对患者的血流动力学影响与开放手术相当。手术适应症选择适当,后腹腔镜肾上腺嗜铬细胞瘤切除术与开放手术具有同样的安全性。
Objective: To evaluate the safety of retroperitoneoscopic adrenal pheochromocytoma resection. Methods: The clinical data of 9 cases of adrenal pheochromocytoma after laparoscopic resection (group A) and 15 cases of retroperitoneal open surgery (group B) were retrospectively analyzed. The operative time, intraoperative blood loss, intraoperative blood transfusion rate , Postoperative intestinal recovery time, postoperative hospital stay, intraoperative and postoperative complications, as well as the blood pressure and heart rate at various time points and the incidence of intraoperative hemodynamic instability were compared and analyzed statistically . Results: The operation time of group A was longer than that of group B, the difference was statistically significant (P <0.05). Blood loss, transfusion rate, postoperative intestinal recovery time, total complication rate, intraoperative and postoperative complication rate had no significant difference between the two groups (P> 0.05). The postoperative hospital stay in group A was shorter than that in group B, the difference was statistically significant (P <0.05). Systolic blood pressure, diastolic blood pressure, heart rate in the two groups were not significantly different at all time points (P> 0.05). There was also no significant difference between the two groups in the incidence of tachycardia, hypotension and hemodynamic instability (P> 0.05). Conclusions: Retroperitoneal laparoscopic adrenalectomy can shorten the postoperative hospital stay without increasing the incidence of complications, and the intraoperative hemodynamic effects are similar to open surgery. Appropriate choice of surgical indications, retroperitoneal adrenal pheochromocytoma resection and open surgery with the same safety.