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目的:评价机器人腹腔镜术治疗嗜铬细胞瘤及合并巨大瘤栓的副神经节瘤的可行性及安全性。方法:回顾性分析2012年6月~2015年10月间所行2例机器人腹腔镜肾上腺嗜铬细胞瘤切除术和1例机器人腹腔镜合并巨大瘤栓的副神经节瘤切除术患者的临床资料:所有患者均有高儿茶酚胺血症的典型临床表现,通过内分泌、核医学和影像学检查定性定位。手术体位均采取侧卧位经腹途径。记录患者一般资料、肿瘤大小、瘤栓长度、手术时间(operating time,OT)、术中失血量(estimated blood loss,EBL)、术后住院天数(hospital stay,HS)及围手术期内分泌指标变化情况,分析手术效果。结果:所有患者手术均获得成功,平均肿瘤直径、瘤栓长度、OT、EBL、HS分别为51mm、100mm、140min、150ml、8.5d,术前患者24h尿去甲肾上腺素均显著升高,术后3、6个月复查各项指标均恢复正常。结论:机器人腹腔镜手术治疗嗜铬细胞瘤及合并巨大瘤栓的副神经节瘤是安全可行的。
OBJECTIVE: To evaluate the feasibility and safety of robotic laparoscopy in the treatment of pheochromocytoma and paraganglioma with giant tumor thrombus. Methods: The clinical data of 2 patients underwent laparoscopic adrenal pheochromocytoma resection from June 2012 to October 2015 and one case of paragangliomas resected by robotic laparoscopy combined with huge tumor thrombus were retrospectively analyzed. : All patients have a typical clinical manifestations of hyper catecholamines, qualitatively identified by endocrinology, nuclear medicine and imaging studies. Surgical positions were taken lateral abdominal approach. The general data of patients, tumor size, tumor embolization length, operating time (OT), blood loss (EBL), hospital stay (HS) and endocrine changes Situation, analysis of surgical results. Results: The operation of all patients was successful. The mean tumor diameter, length of tumor embolus, OT, EBL and HS were 51mm, 100mm, 140min, 150ml and 8.5d, respectively. The urinary norepinephrine 3,6 months after the review of the indicators returned to normal. Conclusions: Robotic laparoscopic surgery for pheochromocytoma and paraganglioma with giant tumor thrombus is safe and feasible.