论文部分内容阅读
目的:探讨经后腹腔镜切除巨大肾上腺肿瘤(直径6≥cm)及肾上腺恶性肿瘤的疗效及安全性。方法:回顾性分析四川省肿瘤医院2007年4月至2014年12月期间收治的经后腹腔镜和开放手术切除的巨大肾上腺肿瘤(直径≥6cm)患者及肾上腺恶性肿瘤患者的临床病理资料,比较两种方法的手术时间、术中出血、住院天数及术后并发症情况。结果:手术切除巨大肾上腺肿瘤患者49例,其中经后腹腔镜腔镜手术21例,开放性手术28例;后腹腔镜组与开放手术组相比,手术时间分别为(149.05±9.35)min、(143.79±12.65)min,两组比较,差异无统计学意义(P=0.754);术后住院天数分别为(9.86±0.58)d、(11.43±0.40)d,两组比较差异无统计学意义(P=0.25),术中出血量分别为(189.52±43.07)m l、(515.71±115.49)ml,差异有统计学意义(P=0.012)。恶性肾上腺肿瘤26例,经后腹腔镜手术13例,开放手术13例,两组比较,手术时间(110.0±22.82)min vs(178.54±65.05)min(P=0.003),后腹腔镜组短于开放手术组;术中出血量(209.23±70.32)ml vs(776.92±202.60)ml(P=0.018)及术后住院天数(9.15±0.59)d vs(12.62±1.21)d(P=0.016)均少于开放手术组,差异有统计学意义。结论:巨大肾上腺肿瘤及恶性肾上腺肿瘤,经充分的术前准备,行后腹腔镜切除术是安全有效的。
Objective: To investigate the efficacy and safety of retroperitoneoscopic laparoscopic resection of giant adrenal tumors (diameter 6 ≧ cm) and adrenal malignancies. Methods: The clinical and pathological data of patients with giant adrenal tumors (diameter≥6cm) and adrenal malignant tumors resected by laparoscopic and open laparoscopic surgery in Sichuan Cancer Hospital from April 2007 to December 2014 were retrospectively analyzed. The two methods of operation time, intraoperative bleeding, hospitalization days and postoperative complications. Results: There were 49 cases of giant adrenal tumor surgically removed, of which 21 cases were treated by retroperitoneoscopic laparoscopic surgery and 28 cases were performed open surgery. Compared with open surgery group, the operative time was (149.05 ± 9.35) min in retroperitoneal group, (143.79 ± 12.65) min, respectively. There was no significant difference between the two groups (P = 0.754). The days after surgery were (9.86 ± 0.58) days and (11.43 ± 0.40) days respectively. There was no significant difference between the two groups (P = 0.25). The blood loss in operation was (189.52 ± 43.07) ml and (515.71 ± 115.49) ml, respectively. The difference was statistically significant (P = 0.012). There were 26 cases of malignant adrenal tumor, 13 cases underwent retroperitoneal laparoscopic surgery and 13 cases underwent open surgery. The operative time was 110.0 ± 22.82 min vs 178.54 ± 65.05 min (P = 0.003) (209.23 ± 70.32) ml vs (776.92 ± 202.60) ml (P = 0.018) and postoperative hospital stay (9.15 ± 0.59) d vs (12.62 ± 1.21) d (P = 0.016) Less than the open surgery group, the difference was statistically significant. Conclusion: Adrenal gland tumors and malignant adrenal tumors, after adequate preoperative preparation, laparoscopic resection is safe and effective.