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目的介绍改进的经腹路径腹腔镜解剖性逆行肾上腺切除术的手术技巧和临床经验。方法回顾性分析2009年1月至2013年1月间行经腹路径腹腔镜解剖性逆行肾上腺切除术47例患者的临床资料,并与同期采用后腹腔镜肾上腺手术36例的临床结果进行比较。结果经腹路径腹腔镜解剖性逆行肾上腺切除组均取得成功。与后腹腔镜组相比,此术式可明显缩短手术时间(45.6±23.4 min vs.115.5±18.2 min);减少术中出血量(25.3±10.6 ml vs.110.6±30.3 ml)。组间比较差异有显著性意义(P<0.001)。无术后并发症发生(0 vs.13.8%)。结论经腹路径腹腔镜解剖性逆行肾上腺切除术分离组织范围小,定位、切除肾上腺快捷,术中出血少,是肾上腺良性病变可靠、安全的腹腔镜手术方式。
Objective To introduce the surgical technique and clinical experience of modified laparoscopic transabdominal retrograde adrenalectomy. Methods The clinical data of 47 patients with transabdominal laparoscopic retrospective retrospective adrenalectomy between January 2009 and January 2013 were retrospectively analyzed and compared with the clinical results of 36 cases treated with retroperitoneal laparoscopic adrenalectomy in the same period. The results of laparoscopic transabdominal laparoscopic retrospective retrospective adrenalectomy group were successful. Compared with the retroperitoneal laparoscopic group, this procedure can significantly shorten the operation time (45.6 ± 23.4 min vs 115.5 ± 18.2 min) and reduce the intraoperative blood loss (25.3 ± 10.6 ml vs.110.6 ± 30.3 ml). The difference between the groups was significant (P <0.001). No postoperative complications occurred (0 vs.13.8%). Conclusion The transabdominal laparoscopic anatomic retrospective adrenalectomy is a reliable and safe method for laparoscopic benign adrenal benign disease because of its small tissue area, small size, location, quick adrenalectomy and less intraoperative bleeding.