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目的:比较与评价腹腔镜与开放手术在治疗肾上腺髓质脂肪瘤中的临床价值。方法:回顾性分析47例接受腹腔镜术和开放手术治疗的肾上腺髓质脂肪瘤患者临床资料,统计分析这两种术式在手术时间、术中出血量、术后肠功能恢复时间、术后住院时间及并发症发生率等方面的差异。结果:37例接受腹腔镜术的患者,除1例因肾周脂肪层过厚、分离困难而中转开放手术外,其余均获得成功。10例接受开放手术的患者均获得成功。两组平均手术时间、平均手术出血量、术后肠功能恢复时间及术后住院天数分别为(128.3±49.6)min和(140.5±43.9)min,(53.3±57.1)ml和(145.5±110.5)ml,(2.1±0.7)天和(2.9±0.7)天,(5.6±1.0)天和(10.7±4.9)天。结论:腹腔镜肾上腺髓质脂肪瘤切除术在手术时间、术中出血量、术后肠功能恢复时间、术后住院时间等方面均优于开放手术,并发症发生率也低于开放手术,可作为肾上腺髓质脂肪瘤外科手术的首选治疗方法。
Objective: To compare and evaluate the clinical value of laparoscopy and open surgery in the treatment of adrenal medullary lipoma. Methods: A retrospective analysis of 47 cases of patients with adrenal medullary lipoma undergoing laparoscopic and open surgery clinical data, statistical analysis of these two surgical procedures in the operation time, blood loss, postoperative intestinal function recovery time, postoperative Hospitalization time and the incidence of complications such as differences. Results: Of the 37 patients undergoing laparoscopic surgery, all except one were surgically transferred to open surgery because of excessive thickening of the perirenal fat layer and difficulty of separation. All 10 patients undergoing open surgery were successful. Mean operative time, mean operative blood loss, postoperative intestinal function recovery time and postoperative hospital stay were (128.3 ± 49.6) min and (140.5 ± 43.9) min, (53.3 ± 57.1) and (145.5 ± 110.5) ml, (2.1 ± 0.7) days and (2.9 ± 0.7) days, (5.6 ± 1.0) days and (10.7 ± 4.9) days, respectively. Conclusions: Laparoscopic adrenal lipoma resection is superior to open surgery in operation time, intraoperative blood loss, postoperative intestinal function recovery time, postoperative hospital stay, etc. The incidence of complications is also lower than that of open surgery As adrenal medullary lipoma surgical treatment of choice for treatment.