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目的探讨腹腔镜技术在肾上腺手术中的临床应用价值。方法2000年12月~2006年5月,对86例肾上腺占位性病变行腹腔镜肾上腺切除术,其中经腹腔途径1例,经腹膜后途径81例,经腹手助腹腔镜4例。结果86例手术全部成功,无中转开放手术,无严重并发症发生。手术时间50~175 min,平均72 min。术中出血量15~120 ml,平均54 ml。术后住院时间5~8 d,平均6.3 d。86例术后随访2~65个月,平均26.5月,影像学检查未见肿瘤复发或转移,功能性肿瘤病人的症状减轻或消失。结论腹腔镜肾上腺切除术创伤小,术中出血少,术后恢复快,是治疗大多数肾上腺占位性病变的首选术式。
Objective To investigate the clinical value of laparoscopy in adrenal surgery. Methods From December 2000 to May 2006, 86 cases of adrenal space-occupying lesions underwent laparoscopic adrenalectomy. Among them, 1 case was treated by peritoneal approach, 81 cases were treated by retroperitoneal approach and 4 cases were treated by abdominal hand laparoscopy. Results All the 86 surgeries were successful. There was no transfer to open surgery and no serious complication occurred. The operation time was 50-175 minutes with an average of 72 minutes. Intraoperative bleeding 15 ~ 120 ml, an average of 54 ml. Postoperative hospital stay 5 to 8 days, an average of 6.3 d. 86 patients were followed up for 2 to 65 months with an average of 26.5 months. No recurrence or metastasis of the tumor was found in the imaging examination. The symptoms of the patients with functional tumor were alleviated or disappeared. Conclusions Laparoscopic adrenalectomy is less invasive, less intraoperative bleeding and faster recovery after surgery. It is the first choice for the treatment of most adrenal space-occupying lesions.